Provider Demographics
NPI:1649494600
Name:KATZ, EVAN (DC)
Entity type:Individual
Prefix:DR
First Name:EVAN
Middle Name:
Last Name:KATZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:EVAN
Other - Middle Name:
Other - Last Name:KATZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:954 NORTH STREET
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3419
Mailing Address - Country:US
Mailing Address - Phone:303-938-9070
Mailing Address - Fax:303-938-9170
Practice Address - Street 1:954 NORTH STREET
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3419
Practice Address - Country:US
Practice Address - Phone:303-938-9070
Practice Address - Fax:303-938-9170
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5016111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor