Provider Demographics
NPI:1588186100
Name:EVANS, EMILY CAROL (DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:CAROL
Last Name:EVANS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 FITNESS WAY STE D
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-2452
Mailing Address - Country:US
Mailing Address - Phone:256-233-9148
Mailing Address - Fax:256-233-9164
Practice Address - Street 1:209 FITNESS WAY STE D
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2452
Practice Address - Country:US
Practice Address - Phone:256-233-9148
Practice Address - Fax:256-233-9164
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH8515225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist