| Organization Name: | EVOLUTION MEDICAL SPA |
| NPI Number: | 1093016412 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KAREN LEE WRIGHT (PHYSICIAN) |
| Mailing Address: | 845 Railroad St Elko |
| State: | NV US |
| Postal Code: | 898013831 |
| Phone Number: | 7753854377 |
| Fax Number: | |
| NPI Enumeration Date: | 11/17/2010 |
| NPI Last Update Date: | 01/31/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 10643 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NV |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |