Provider Demographics
NPI:1902987381
Name:EAKIN, ARTHA LAUREL (DC, LAC)
Entity Type:Individual
Prefix:
First Name:ARTHA
Middle Name:LAUREL
Last Name:EAKIN
Suffix:
Gender:F
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 116
Mailing Address - Street 2:209 S. RIPLEY
Mailing Address - City:BROOKSTON
Mailing Address - State:IN
Mailing Address - Zip Code:47923-0116
Mailing Address - Country:US
Mailing Address - Phone:765-563-4090
Mailing Address - Fax:
Practice Address - Street 1:903 S. PRAIRIE ST.
Practice Address - Street 2:
Practice Address - City:BROOKSTON
Practice Address - State:IN
Practice Address - Zip Code:47923-0116
Practice Address - Country:US
Practice Address - Phone:765-563-4090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001797A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200237820AMedicaid
IN921510Medicare ID - Type UnspecifiedMEDICARE PRACTICE NUMBER