Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 4574 | IA |
NPI | 1770571929 |
---|---|
Provider Name | Dr. Ronald Charles Evans |
First Address | West Des Moines, IA 50266-1309 |
Second Address | West Des Moines, IA 50266-1309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 08/07/2007 |