Individual
MR. JASON ANTHONY EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
224 W D. L. INGRAM AVENUE, BLDG. 1408, CANNON AFB, NM 88101
(310) 686-2656
Mailing address
8808 CLOVIS CT APT A, CLOVIS, NM 88101-8593
(310) 686-2656
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
04/05/2013
Last updated
03/22/2024
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