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General NPI Number Information
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NPI Number | 1629388434
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Entity Type | Organization
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Legal Business Name | EVANS CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 3679 NOTTINGHAM WAY STE A
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City | HAMILTON
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State | NJ
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Zip | 08690-2611
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Country | US
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Telephone | 609-586-9199
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Fax | 609-586-5766
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Provider Business Mailing Address
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Address Line | 3679 NOTTINGHAM WAY STE A
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City | HAMILTON
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State | NJ
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Zip | 08690-2611
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Country | US
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Telephone | 609-586-9199
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Fax | 609-586-5766
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Authorized Official
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Title or Position | OWNER
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Name | DR. ERIC T EVANS
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Credential | D.C.
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Telephone | 609-392-5001
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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 | 38MC0053800
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License Number State | NJ
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