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Individual

SCOTT RYAN EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1000 N 1ST ST, ALBEMARLE, NC 28001-2833
(704) 983-2117
Mailing address
1305 S CANNON BLVD, KANNAPOLIS, NC 28083-6232

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6103743
NC
Enumeration date
06/08/2007
Last updated
12/10/2007
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