Provider Demographics
NPI:1982989539
Name:EASTON HEALTH SOLUTIONS
Entity type:Organization
Organization Name:EASTON HEALTH SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:WUOTILA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-230-2323
Mailing Address - Street 1:285 WASHINGTON ST STE 4
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-1117
Mailing Address - Country:US
Mailing Address - Phone:508-230-2323
Mailing Address - Fax:508-230-8223
Practice Address - Street 1:105 WASHINGTON ST
Practice Address - Street 2:SUITE 4
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-1100
Practice Address - Country:US
Practice Address - Phone:508-230-2323
Practice Address - Fax:508-230-8223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-14
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3246111N00000X
MA3353111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0014054OtherMEDICARE PTAN