Individual
MIKE EVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1124 WASHINGTON BLVD, NEWCASTLE, WY 82701-2972
(307) 746-3720
(307) 746-3723
Mailing address
1124 WASHINGTON BLVD, NEWCASTLE, WY 82701-2972
(307) 746-3720
(307) 746-3723
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1421
WY
Other
Enumeration date
03/09/2017
Last updated
03/09/2017
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