Provider Demographics
NPI:1528820867
Name:ST CLAIR, ELDON (C ACU)
Entity type:Individual
Prefix:
First Name:ELDON
Middle Name:
Last Name:ST CLAIR
Suffix:
Gender:M
Credentials:C ACU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 E 21ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-1958
Mailing Address - Country:US
Mailing Address - Phone:918-439-4434
Mailing Address - Fax:
Practice Address - Street 1:3401 E 21ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-1958
Practice Address - Country:US
Practice Address - Phone:918-439-4434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist