Individual
MR. MATTHEW DYLAN EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2600 W 16TH ST, YUMA, AZ 85364-4214
(928) 329-2795
(928) 329-0337
Mailing address
PO BOX 1241, YUMA, AZ 85366-1241
(928) 329-2795
(928) 329-0337
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11960
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11960
STATE LICENSE
AZ
Enumeration date
04/04/2007
Last updated
07/08/2007
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