Individual
KODIE THOMAS EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25072 NORTHWESTERN PIKE, ROMNEY, WV 26757-5039
(304) 822-2177
Mailing address
PO BOX 288, ROMNEY, WV 26757-0288
(304) 822-2177
(304) 822-4977
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2057
WV
Other
Enumeration date
07/12/2022
Last updated
07/12/2022
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