Individual
MR. FRED L. EVANS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2439 WILLWOOD DR., FLORENCE, SC 29501
(843) 777-2196
Mailing address
P.O BOX 1116, LAMAR, SC 29069
(843) 616-4488
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3241
SC
Other
Enumeration date
01/16/2019
Last updated
01/16/2019
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