Provider Demographics
NPI:1710362249
Name:EVANS, CHRISSY (PTA)
Entity Type:Individual
Prefix:
First Name:CHRISSY
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:PROF
Other - First Name:CHRISSY
Other - Middle Name:
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:2918 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4802
Mailing Address - Country:US
Mailing Address - Phone:501-279-9255
Mailing Address - Fax:501-305-2594
Practice Address - Street 1:2302 LLAMA DR
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4793
Practice Address - Country:US
Practice Address - Phone:501-268-5001
Practice Address - Fax:501-268-5443
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225200000X
ARPTA3967225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant