Individual
MR. EVAN ROBERT UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1930 N BUSINESS ROUTE 5 UNIT 1B, CAMDENTON, MO 65020-2659
(573) 346-7445
Mailing address
10415 REDFIELD LN, EUGENE, MO 65032
(573) 380-1785
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2019016835
MO
Other
Enumeration date
05/29/2019
Last updated
05/29/2019
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