MEDICARE: JOHN SCOTT EVANS PT

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	225100000X	Physical Therapist	00540	IA

General Provider Information

NPI Number	:	1356644603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN SCOTT EVANS PT

Provider Business Mailing Address
First Line	:	1002 S LINCOLN ST
Second Line	:
City	:	KNOXVILLE
State	:	IA
Zip	:	50138-3155
Country	:	US
Telephone Number	:	641-842-2151
Fax Number	:	641-842-1481

Provider Business Practice Location Address
First Line	:	1008 W BELL AVE
Second Line	:	SUITE 105
City	:	KNOXVILLE
State	:	IA
Zip	:	50138-3100
Country	:	US
Telephone Number	:	641-828-7211
Fax Number	:	641-842-3791

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2010
Last Update Date	:	02/10/2011

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Directions to “ JOHN SCOTT EVANS PT” Practice Location

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