Individual
SAMUEL EVELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
13230 MANCHESTER RD, SAINT LOUIS, MO 63131-1706
(314) 480-5259
Mailing address
5405 ROBERT AVE, SAINT LOUIS, MO 63109-4065
(314) 680-5266
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2014024451
MO
Other
Enumeration date
07/24/2014
Last updated
07/24/2014
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