Provider Demographics
NPI:1285271593
Name:EASTERN THERAPEUTICS, LLC
Entity type:Organization
Organization Name:EASTERN THERAPEUTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ROBINSON-CAPY
Authorized Official - Suffix:
Authorized Official - Credentials:MACM LIC AC
Authorized Official - Phone:508-668-6542
Mailing Address - Street 1:50 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WALPAZ
Mailing Address - State:MA
Mailing Address - Zip Code:02001
Mailing Address - Country:US
Mailing Address - Phone:500-668-6542
Mailing Address - Fax:
Practice Address - Street 1:50 MAIN ST
Practice Address - Street 2:
Practice Address - City:WALPAZ
Practice Address - State:MA
Practice Address - Zip Code:02001
Practice Address - Country:US
Practice Address - Phone:500-668-6542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty