Provider Demographics
NPI:1326134156
Name:PICKETT, EVANA DION (DC)
Entity Type:Individual
Prefix:DR
First Name:EVANA
Middle Name:DION
Last Name:PICKETT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 582
Mailing Address - Street 2:2694 THOMASVILLE
Mailing Address - City:POCAHONTAS
Mailing Address - State:AR
Mailing Address - Zip Code:72455
Mailing Address - Country:US
Mailing Address - Phone:870-892-3337
Mailing Address - Fax:870-892-3337
Practice Address - Street 1:2694 THOMASVILLE RD
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:AR
Practice Address - Zip Code:72455-1202
Practice Address - Country:US
Practice Address - Phone:870-892-3337
Practice Address - Fax:870-892-3337
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1333111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic