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Organization
ONE SOURCE INTEGRATIVE MEDICINE
Active
Organization
ONE SOURCE INTEGRATIVE MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER M EVANS DC (OWNER)
(843) 992-7604
Entity
Organization
Contact information
Practice address
1601A W LUCAS ST, FLORENCE, SC 29501-1225
(843) 992-7604
Mailing address
3202 W FOREST LAKE DR, FLORENCE, SC 29501-8267
(843) 992-7604
(843) 799-4784
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
Other
Enumeration date
02/10/2022
Last updated
02/10/2022
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