Healthcare Provider Details

I. General information

NPI: 1861978512
Provider Name (Legal Business Name): EVOLVE PHYSICAL THERAPY AND PERFORMANCE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2018
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 CLOVIS AVE
CLOVIS CA
93612-1116
US

IV. Provider business mailing address

340 CLOVIS AVE
CLOVIS CA
93612-1116
US

V. Phone/Fax

Practice location:
  • Phone: 608-239-4249
  • Fax:
Mailing address:
  • Phone: 559-650-0345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT292568
License Number StateCA

VIII. Authorized Official

Name: RANDY HILL
Title or Position: OWNER/PHYSICAL THERAPIST
Credential:
Phone: 559-573-6594