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1194129304
CHARLES EVANS II
HURRICANE, WV
NPI
1194129304
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: WV 950)
Enumeration Date
2014-10-17
Last Update Date
2014-10-17
Business Address
CHARLES EVANS II
4000 OUT LOOK DR
HURRICANE, WV 25526-9467
Phone number: 304-757-4102
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Mailing Address
CHARLES EVANS II
4000 OUT LOOK DR
HURRICANE, WV 25526-9467
Phone number: 304-757-4102
Copy
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