Provider Demographics
NPI:1821569849
Name:SCHWARTZ, EVAN CHRISTIAN (PTA)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:CHRISTIAN
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600A VILLAGE WALK DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-4438
Mailing Address - Country:US
Mailing Address - Phone:919-346-8651
Mailing Address - Fax:
Practice Address - Street 1:600A VILLAGE WALK DR
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-4438
Practice Address - Country:US
Practice Address - Phone:919-346-8651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA6597225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant