Evolutions On Fifth, LLC

NPI #1346916632 in Columbus, Mississippi

Provider Information

NPI Number: 1346916632
Entity Type: Organization
Organization Name: Evolutions On Fifth, LLC
Primary Specialty: Mechanotherapist
Enumeration Date: Aug 18, 2021
Last Updated: Aug 18, 2021

Practice Location

Address: 122 5TH ST N
City: Columbus
State: Mississippi
ZIP Code: 39701-4522
Phone: (662) 630-5160

Authorized Official

Name: MR. JEFF BOLLING
Title: DIRECTOR
Phone: (662) 497-0457

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Mechanotherapist	172M00000X	Primary

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