Provider Demographics
NPI:1821689845
Name:EVENS PHYSICAL THERAPY
Entity Type:Organization
Organization Name:EVENS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:R
Authorized Official - Last Name:EVENS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:541-285-7070
Mailing Address - Street 1:1821 NE BOBBIE CT
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6609
Mailing Address - Country:US
Mailing Address - Phone:541-285-7070
Mailing Address - Fax:
Practice Address - Street 1:2753 NW LOLO DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-7288
Practice Address - Country:US
Practice Address - Phone:541-285-7070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty