Ben Michael Evardome, PTA
NPI #1164754875 in Yucaipa, California
Provider Information
- NPI Number
- 1164754875
- Entity Type
- Individual
- Name
- Ben Michael Evardome, PTA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physical Therapy Assistant
- Credential
- PTA
- Enumeration Date
- Feb 4, 2010
- Last Updated
- Feb 4, 2010
Practice Location
- Address
- 34835 FAIRPORT WAY
- City
- Yucaipa
- State
- California
- ZIP Code
- 92399-6817
- Phone
- (909) 570-9573
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapy Assistant |
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