Provider Demographics
NPI:1124711338
Name:EATON, CORMICK (DPT)
Entity type:Individual
Prefix:DR
First Name:CORMICK
Middle Name:
Last Name:EATON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 W COLLINS DR
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2448
Mailing Address - Country:US
Mailing Address - Phone:307-333-2943
Mailing Address - Fax:307-333-2908
Practice Address - Street 1:128 W COLLINS DR
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2448
Practice Address - Country:US
Practice Address - Phone:307-333-2943
Practice Address - Fax:307-333-2908
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic