Provider Demographics
NPI:1982765400
Name:EVANS, DAVID C (DC, CCSP)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:EVANS
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8061 SHAFFER PKWY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-3762
Mailing Address - Country:US
Mailing Address - Phone:303-973-4700
Mailing Address - Fax:
Practice Address - Street 1:8061 SHAFFER PKWY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-3762
Practice Address - Country:US
Practice Address - Phone:303-973-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2691111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU60829Medicare UPIN
CO23283Medicare ID - Type Unspecified