Individual
ANTHONY LEE EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
509 S MAIN ST STE 20, PETAL, MS 39465-2203
(601) 336-4144
(601) 582-7697
Mailing address
509 S MAIN ST STE 20, PETAL, MS 39465-2203
(601) 336-4144
(601) 582-7697
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06804375
—
MS
Enumeration date
02/21/2022
Last updated
02/21/2022
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