Individual
MR. JEREMY WAYNE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA MT
Contact information
Practice address
711 RUSH AVE, BELLEFONTAINE, OH 43311
(937) 592-1625
(937) 592-3489
Mailing address
711 RUSH AVE, BELLEFONTAINE, OH 43311
(937) 592-1625
(937) 592-3489
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
PTA06368
OH
225700000X
Massage Therapist
Primary
33011899
OH
Other
Enumeration date
10/12/2006
Last updated
09/11/2025
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