Individual
JEFFERY SCOTT EVANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
84 PINE ST, NEWPORT, NH 03773-2005
(603) 863-1020
(603) 863-4964
Mailing address
487 BOROUGH RD, CHARLESTOWN, NH 03603-4420
(603) 826-4145
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0857
NH
Other
Enumeration date
06/20/2007
Last updated
07/08/2007
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