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General NPI Number Information
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NPI Number | 1659499457
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Entity Type | Individual
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Provider Name | JENNIFER JOY EVANS PT, OCS
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Gender | Female
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 1650 COCHRANE CIR BLDG 7503, ROOM 3236
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City | FORT CARSON
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State | CO
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Zip | 80913-4613
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Country | US
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Telephone | 719-526-7604
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Fax |
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Provider Business Mailing Address
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Address Line | CMR 467 BOX 5824
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City | APO
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State | AE
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Zip | 09096-0059
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Country | US
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Telephone | 303-229-7352
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 9001
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License Number State | CO
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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 | 9001
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License Number State | CO
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