Provider Demographics
NPI:1922274299
Name:EVANS, JAMES H JR (LAC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:H
Last Name:EVANS
Suffix:JR
Gender:M
Credentials:LAC
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Mailing Address - Street 1:265 PARKSIDE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3141
Mailing Address - Country:US
Mailing Address - Phone:719-304-2873
Mailing Address - Fax:719-475-2227
Practice Address - Street 1:265 PARKSIDE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3141
Practice Address - Country:US
Practice Address - Phone:719-304-2873
Practice Address - Fax:719-475-2227
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO1089171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist