JONATHAN T EVANS

PROTAILORED PHYSICAL THERAPY LLC

Dr JONATHAN T EVANS is a male medical professional, specializing in Physical Therapy. He graduated in 2011 from Emory University School Of Medicine.

Contact

PROTAILORED PHYSICAL THERAPY LLC

12722 TONKEL RD
FORT WAYNE
IN
468458200

Tel: 2607390300

JONATHAN T EVANS Information

Npi 1033493622
Pac Id 4284952391
Professional Enrollment Id I20150421000673
Last Name EVANS
First Name JONATHAN
Middle Name T
Suffix
Gender M
Credential
Medical School Name EMORY UNIVERSITY SCHOOL OF MEDICINE
Graduation Year 2011
Primary Specialty PHYSICAL THERAPY
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name PROTAILORED PHYSICAL THERAPY LLC
Group Practice Pac Id 4385962497
Number Of Group Practice Members 3
Line 1 Street Address 12722 TONKEL RD
Line 2 Street Address
Marker Of Address Line 2 Suppression
City FORT WAYNE
State IN
Zip Code 468458200
Phone Number 2607390300
Hospital Affiliation Ccn 1
Hospital Affiliation Lbn 1
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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