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General NPI Number Information
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NPI Number | 1336234517
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Entity Type | Individual
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Provider Name | CORY T EVANS D.C, CNIM
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 08/13/2013
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Provider Practice Location Address
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Address Line | 13 S TEJON ST STE 501
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City | COLORADO SPRINGS
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State | CO
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Zip | 80903-1530
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Country | US
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Telephone | 866-226-8576
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Fax | 866-286-0255
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Provider Business Mailing Address
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Address Line | 306 E 5TH ST
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City | RUSHVILLE
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State | IN
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Zip | 46173-1627
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Country | US
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Telephone | 765-265-0698
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 08002019A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5020
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number | 1687
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License Number State |
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