Provider Demographics
NPI:1972028926
Name:EASTMAN, JOSIAH (PT, DPT, ATC, LAT)
Entity type:Individual
Prefix:
First Name:JOSIAH
Middle Name:
Last Name:EASTMAN
Suffix:
Gender:M
Credentials:PT, DPT, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36491 DUTCHTOWN GARDENS AVE
Mailing Address - Street 2:
Mailing Address - City:GEISMAR
Mailing Address - State:LA
Mailing Address - Zip Code:70734-3081
Mailing Address - Country:US
Mailing Address - Phone:225-744-7325
Mailing Address - Fax:225-744-7330
Practice Address - Street 1:36491 DUTCHTOWN GARDENS AVE
Practice Address - Street 2:
Practice Address - City:GEISMAR
Practice Address - State:LA
Practice Address - Zip Code:70734-3081
Practice Address - Country:US
Practice Address - Phone:225-744-7325
Practice Address - Fax:225-744-7330
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09665225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist