Individual
AMY D EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
910 N JEFFERSON ST, JACKSONVILLE, FL 32209-6810
(904) 360-7022
Mailing address
322 PABLO RD, PONTE VEDRA BEACH, FL 32082-1806
(904) 280-1694
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
225100000X
Physical Therapist
Primary
PT26258
FL
2251P0200X
Pediatric Physical Therapist
PT26258
FL
Other
Enumeration date
09/16/2009
Last updated
03/13/2019
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