Tina G Evans, MASSAGE THERAPIST

NPI #1649488933 in Port Orange, Florida

Provider Information

NPI Number: 1649488933
Entity Type: Individual
Name: Tina G Evans, MASSAGE THERAPIST
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: MASSAGE THERAPIST
Enumeration Date: May 18, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 16 BLACK JACK CIR
City: Port Orange
State: Florida
ZIP Code: 32128-6771
Phone: (386) 756-0505

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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