Organization
EAGLE HEALTHY LIVING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BRYANT (DIRECTOR OF CLINICAL OPERATIONS)
(708) 692-2903
Entity
Organization
Contact information
Practice address
16057 SCHOOL ST, SOUTH HOLLAND, IL 60473-1630
(708) 692-2903
Mailing address
16057 SCHOOL ST, SOUTH HOLLAND, IL 60473-1630
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
209011607
IL
Other
Enumeration date
07/01/2015
Last updated
07/22/2016
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