Individual
CONNIE EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
204 HARNETT CT STE A, CLARKSVILLE, TN 37043-2068
(931) 378-0553
Mailing address
511 RINGGOLD RD, CLARKSVILLE, TN 37042-3405
(931) 378-0553
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11933
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11933
LICENSED MASSAGE THERAPIST
TN
Enumeration date
12/05/2018
Last updated
12/05/2018
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