Individual
MR. JOSHUA R EVANS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5098 HEARTHSTONE PARK DR, NEW ALBANY, OH 43054-7900
(740) 919-1147
Mailing address
PO BOX 281, NEW ALBANY, OH 43054-0281
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
372600000X
Adult Companion
Primary
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0218478
—
OH
Enumeration date
11/03/2017
Last updated
06/16/2018
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