| Provider / Organization | NPI | Date Certified |
|---|---|---|
| EVAN M RAVELY | 1457950834 | 2020-10-18 |
Evan M Ravely is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1457950834. Registration indicates Evan M Ravely is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Physical Therapy Assistant (Physical Therapy Assistant, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Physical Therapy Assistant, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)
| Entity Type | Individual |
| Provider Name | Evan M Ravely PTA |
| Practice Office Address | 27600 ENCANTO DR MENIFEE, CA US |
| Practice Office Telephone | 9513852421 |
| Mailing Address | 23832 FALCONER DR MURRIETA, CA 925624611 US |
| Business Telephone | 9513852421 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 23832 Falconer Dr | Murrieta, CA 925624611 | 9513852421 |
| Code | Practice | License No State |
|---|---|---|
| 225200000X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapy Assistant Physical Therapy Assistant Speech/Occupational/Physical Therapy/Chiropractor Physical Therapy Assistant Respiratory, Developmental, Rehabilitative and Restorative Service Providers | AT8384
CA |