Provider Demographics
NPI:1942329354
Name:EVANS, KIRK C (DC)
Entity Type:Individual
Prefix:
First Name:KIRK
Middle Name:C
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 1:892 S DUPONT BLVD
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-1723
Mailing Address - Country:US
Mailing Address - Phone:302-653-5525
Mailing Address - Fax:302-653-7010
Practice Address - Street 1:892 S DUPONT BLVD
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-1723
Practice Address - Country:US
Practice Address - Phone:302-653-5525
Practice Address - Fax:302-653-7010
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000640111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor