# ONE SOURCE INTEGRATIVE MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912651647
- **Authorized official:** DR. JENNIFER M EVANS DC (OWNER)
- **Authorized official phone:** (843) 992-7604

## Contact information

- **Practice address:** 1601A W LUCAS ST, FLORENCE, SC 29501-1225
- **Practice address phone:** (843) 992-7604
- **Mailing address:** 3202 W FOREST LAKE DR, FLORENCE, SC 29501-8267
- **Mailing address phone:** (843) 992-7604
- **Mailing address fax:** (843) 799-4784

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 02/10/2022
- **Last updated:** 02/10/2022