Provider Demographics
NPI:1699166371
Name:EVANS, CRAIG S (DC)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:S
Last Name:EVANS
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 1:6 GLADSTONE CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1909
Mailing Address - Country:US
Mailing Address - Phone:724-549-7814
Mailing Address - Fax:856-228-3108
Practice Address - Street 1:3 JEFFERSON DR
Practice Address - Street 2:
Practice Address - City:LAUREL SPRINGS
Practice Address - State:NJ
Practice Address - Zip Code:08021-2719
Practice Address - Country:US
Practice Address - Phone:856-228-3100
Practice Address - Fax:856-228-3108
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00723400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor