MEDICARE: EVANS FAMILY CHIROPRACTIC LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center	B-354	NV

General Provider Information

NPI Number	:	1144552266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVANS FAMILY CHIROPRACTIC LTD

Provider Business Mailing Address
First Line	:	4555 E CHARLESTON BLVD STE 101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-5510
Country	:	US
Telephone Number	:	702-457-2225
Fax Number	:	702-457-8680

Provider Business Practice Location Address
First Line	:	4555 E CHARLESTON BLVD STE 101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-5510
Country	:	US
Telephone Number	:	702-457-2225
Fax Number	:	702-457-8680

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DONALD AMUSSEN EVANS
Credential	:	D.C.
Telephone Number	:	702-457-2225

Provider Enumeration Date	:	02/01/2010
Last Update Date	:	02/01/2010

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