Provider Demographics
NPI:1851470843
Name:EVANS, MITCHELL (DC)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:
Last Name:EVANS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 W MEADOWVIEW RD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-3720
Mailing Address - Country:US
Mailing Address - Phone:336-547-8811
Mailing Address - Fax:336-547-8811
Practice Address - Street 1:2300 W MEADOWVIEW RD
Practice Address - Street 2:SUITE 121
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3720
Practice Address - Country:US
Practice Address - Phone:336-547-8811
Practice Address - Fax:336-547-8811
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3399111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation