Individual
CHAD EVENTIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MHS, PA-C
Contact information
Practice address
50 BRANSCOMB RD, LAYTONVILLE, CA 95454
(707) 984-6131
Mailing address
89 MILL CREEK DR, WILLITS, CA 95490-3023
(919) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/14/2011
Last updated
12/14/2011
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