Provider Demographics
NPI:1194983809
Name:EVERTS, ANDREW CARL (OT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:CARL
Last Name:EVERTS
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6274 BLUFF ACRES DR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-9035
Mailing Address - Country:US
Mailing Address - Phone:317-859-9189
Mailing Address - Fax:
Practice Address - Street 1:6274 BLUFF ACRES DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-9035
Practice Address - Country:US
Practice Address - Phone:317-859-9189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist