Provider Demographics
NPI:1194096339
Name:ROWE, EVAN LEE (DC)
Entity type:Individual
Prefix:DR
First Name:EVAN
Middle Name:LEE
Last Name:ROWE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3512 EVANS RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72936-7904
Mailing Address - Country:US
Mailing Address - Phone:479-414-4637
Mailing Address - Fax:
Practice Address - Street 1:3512 EVANS RD
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:AR
Practice Address - Zip Code:72936-7904
Practice Address - Country:US
Practice Address - Phone:479-414-4637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15965111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor