Individual
CHARLES EVANS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4000 OUT LOOK DR, HURRICANE, WV 25526-9467
(304) 757-4102
Mailing address
4000 OUT LOOK DR, HURRICANE, WV 25526-9467
(304) 757-4102
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
950
WV
Other
Enumeration date
10/17/2014
Last updated
10/17/2014
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