Evans, Tina G
Evans, Tina G is an sole proprietor health care provider with primary practice located at 16 Black Jack Cir , Port Orange FL 32128-6771. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Evans, Tina G can be contacted via phone (386) 756-0505.Contact Information
Primary practice address
16 Black Jack Cir
Port Orange FL 32128-6771
Phone: (386) 756-0505
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | MA34834 | Florida |
Profile Details
| NPI number | 1649488933 |
|---|---|
| LBN Legal business name | Evans, Tina G |
| Credentials | MASSAGE THERAPIST |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 18th, 2007 |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649488933 | NPPES |
| Florida | Other | MA34834 | MASSAGE LICENSE |
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