Individual
DEIRDRA EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
1330 BOILING SPRINGS RD, STE 1600B, SPARTANBURG, SC 29303-4201
(864) 582-0019
Mailing address
1330 BOILING SPRINGS RD, SUITE 1600B, SPARTANBURG, SC 29303-4201
(864) 582-0019
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
502
LICENSE#
SC
Enumeration date
11/01/2006
Last updated
07/08/2007
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