Individual
EVAN SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4210 E BASELINE RD, 106, MESA, AZ 85206-4417
(480) 503-2373
(480) 782-5213
Mailing address
4210 E BASELINE RD, 106, MESA, AZ 85206-4417
(480) 503-2373
(480) 782-5213
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11733
AZ
Other
Enumeration date
08/06/2015
Last updated
08/06/2015
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