MEDICARE: JAMES CHRISTOPHER EVANS HEALTH COACH (CHC)

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	171400000X	Health & Wellness Coach	W58029	GA

General Provider Information

NPI Number	:	1922846310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES CHRISTOPHER EVANS HEALTH COACH (CHC)

Provider Business Mailing Address
First Line	:	4683 OAKLEIGH MANOR DR
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-4922
Country	:	US
Telephone Number	:	706-424-0528
Fax Number	:

Provider Business Practice Location Address
First Line	:	4683 OAKLEIGH MANOR DR
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-4922
Country	:	US
Telephone Number	:	706-424-0528
Fax Number	:

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

Provider Enumeration Date	:	07/18/2024
Last Update Date	:	07/18/2024

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