NPI 1083149140

Audrey Evanson, LMT

Practitioner Massage Therapist Lisbon, ND

Practice location

Address: 416 Main St, Lisbon, ND 58054-4142
Phone: (701) 680-9167
Mailing address: 14061 62 1/2 St SE, Lisbon, ND 58054-9421

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 1729 (ND)

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Registry record

NPI: 1083149140
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Apr 2017
Record last updated: 26 Apr 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.