Provider Demographics
NPI:1538235080
Name:EYTON, CLAIRE DILLON (PT)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:DILLON
Last Name:EYTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:DILLON
Other - Last Name:WALLACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2121 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501
Mailing Address - Country:US
Mailing Address - Phone:707-442-6463
Mailing Address - Fax:707-442-5427
Practice Address - Street 1:2822 HARRIS ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503
Practice Address - Country:US
Practice Address - Phone:707-445-8881
Practice Address - Fax:707-445-8883
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25252225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist