Individual
MR. KENT WILLIAM EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC/L
Contact information
Practice address
6215 S FRANKLIN RD, INDIANAPOLIS, IN 46259-9600
(317) 803-5676
(317) 862-7262
Mailing address
8130 FENDLER DR, INDIANAPOLIS, IN 46259-9793
(317) 862-5072
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000112A
IN
Other
Enumeration date
07/12/2006
Last updated
07/08/2007
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