Davis, Evan L

Davis, Evan L is an individual health care provider with primary practice located at 901 W Morton Ave Suite 16A, Jacksonville IL 62650-3146. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Davis, Evan L can be contacted via phone (217) 245-4640.

Contact Information

Primary practice address
901 W Morton Ave Suite 16A Jacksonville IL 62650-3146
Phone: (217) 245-4640
Fax: (217) 245-4642
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X Illinois

Profile Details

NPI number 1023078714
LBN Legal business name Davis, Evan L
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023078714 NPPES
Other WASHINGTON UNIV SCHOOL

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