Individual
EVAN ROEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
8912 BLAKENEY PROFESSIONAL DR STE 100, CHARLOTTE, NC 28277-6735
(704) 544-5353
Mailing address
222 E BLAND ST UNIT 3, CHARLOTTE, NC 28203-6111
(717) 649-3509
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
5493
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5493
NORTH CAROLINA
NC
Enumeration date
05/13/2022
Last updated
05/13/2022
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