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Individual

DONALD RYAN EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
421 S BEST AVE, WALNUTPORT, PA 18088-1217
(610) 760-1520
(610) 760-1721
Mailing address
421 S BEST AVE, WALNUTPORT, PA 18088-1217
(610) 760-1520
(610) 760-1721

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
46TR00311700
NJ
225X00000X
Occupational Therapist
Primary
OC005079L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001676374
PA
Enumeration date
06/13/2005
Last updated
01/19/2012
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