Evans, Charles Matthew

Evans, Charles Matthew is an individual health care provider with primary practice located at 5737 Barnhill Dr Ste 204 Credentialing Department, Jacksonville FL 32207-7189. 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. Evans, Charles Matthew can be contacted via phone (904) 733-9948.

Contact Information

Primary practice address
5737 Barnhill Dr Ste 204 Credentialing Department Jacksonville FL 32207-7189
Phone: (904) 733-9948
Fax: (904) 733-9984
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT18037 Florida

Profile Details

NPI number 1174528285
LBN Legal business name Evans, Charles Matthew
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2005
Last updated Feb 4th, 2015 - about 9 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 1174528285 NPPES
Florida Other P00212647 RR MEDICARE

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