Individual provider · Type 1 NPI

Ben Michael Evardome, PTA

Physical Therapy Assistant · Yucaipa, CA

NPI number 1164754875 Active

Practice location

34835 Fairport Way
Yucaipa, CA 92399-6817

Fax (909) 570-9573

Specialties and licenses

Taxonomy	Code	License
Physical Therapy Assistant Primary	225200000X	AT6602 (CA)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1164754875

Ben Michael Evardome, PTA's National Provider Identifier is 1164754875, issued on Feb 4, 2010. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Yucaipa, CA. The record was last updated on Feb 4, 2010.