Individual
MR. CHARLES EDWARD EVANS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
12001 IRON BRIDGE RD, CHESTER, VA 23831-1460
(804) 706-1023
Mailing address
1311 BULL RUN DR, RICHMOND, VA 23231-5103
(804) 714-4859
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000006
VA
Other
Enumeration date
10/13/2014
Last updated
10/13/2014
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