Doctor Name: | MRS. KELLI D EVANS |
NPI Number: | 1265448799 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSRPT |
License Number: | |
Business Practice Address: | 16 Ginger Creek Pkwy Glen Carbon, IL - 620343502 |
Business Phone Number: | 6186561122 |
Business Fax Number: | 6186561171 |
Mailing Address: | 5 Bear Creek Ct, GLEN CARBON |
State: | IL |
Postal Code: | 620341377 |
Phone Number: | 6182881336 |
Fax Number: | |
NPI Enumeration Date: | 08/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |