SearchMississippi253Z00000X

Anthony Evans

NPI 1922753755 · on the registry since 2022 · sole proprietor

Practice

Address
509 S Main St Ste 20
Petal, MS 39465
Phone
(601) 336-4144
Fax
(601) 582-7697
Organisation at this address
Fit Jam Llc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
253Z00000X
253Z00000X
Licence states on file
MS
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2022-02-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi