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General NPI Number Information
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NPI Number | 1093715773
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Entity Type | Organization
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Legal Business Name | EVANS REHABILITATION SERVICES, LLC
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Dates
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Enumeration Date | 07/26/2005
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 415 TOWN PARK BLVD SUITE 201
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City | EVANS
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State | GA
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Zip | 30809
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Country | US
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Telephone | 706-868-1707
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Fax | 706-868-1351
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Provider Business Mailing Address
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Address Line | 415 TOWN PARK BLVD.
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City | EVANS
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State | GA
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Zip | 30809
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Country | US
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Telephone | 706-868-1707
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Fax | 706-868-1351
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Authorized Official
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Title or Position | OWNER
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Name | MR. JASON A LOTT
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Credential | PT
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Telephone | 706-868-1707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | GA
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