Individual
MATTHEW EASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
2854 CORAL COURT, STE 1, ON WITH LIFE OUTPATIENT NEURO REHABILITATION, CORALVILLE, IA 52241
(319) 259-6224
(319) 249-6643
Mailing address
715 SW ANKENY RD, ANKENY, IA 50023-9798
(515) 289-9696
(515) 289-9649
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
097425
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42-1308032
—
IA
Enumeration date
11/27/2019
Last updated
11/27/2019
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