Organization
EVANS LOGISTIC SERVICES LLC
Active
Organization
EVANS LOGISTIC SERVICES LLC
Active
Other names
Evans Logistic Services LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TERRENCE EVANS (MEDICAID WAIVER PROVIDER)
(352) 361-2968
Entity
Organization
Contact information
Practice address
12630 NW 38TH AVE, REDDICK, FL 32686-4067
(352) 361-2968
Mailing address
12630 NW 38TH AVE, REDDICK, FL 32686-4067
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
06/21/2019
Last updated
06/21/2019
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