Provider Demographics
NPI:1548212012
Name:EVANS, CHRISTOPHER PAUL (MPT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:PAUL
Last Name:EVANS
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:MR
Other - First Name:CHRIS
Other - Middle Name:P
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPT
Mailing Address - Street 1:70 E HORIZON RIDGE PKWY
Mailing Address - Street 2:#180
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-7935
Mailing Address - Country:US
Mailing Address - Phone:702-856-0422
Mailing Address - Fax:702-433-0425
Practice Address - Street 1:70 E HORIZON RIDGE PKWY
Practice Address - Street 2:#180
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7935
Practice Address - Country:US
Practice Address - Phone:702-856-0422
Practice Address - Fax:702-433-0425
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1471225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV100885Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER