Healthcare Provider Details

I. General information

NPI: 1013046721
Provider Name (Legal Business Name): EVAN V. HELLWIG PHD, ATC, PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 N MAIN ST
CEDARVILLE OH
45314-8501
US

IV. Provider business mailing address

620 WELLINGTON DR
SPRINGFIELD OH
45506-3751
US

V. Phone/Fax

Practice location:
  • Phone: 937-766-7691
  • Fax: 937-766-2795
Mailing address:
  • Phone: 937-323-3329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number04208
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number000606
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: