Provider Demographics
NPI:1053006890
Name:EVOLUTION HEALTH CENTER INC
Entity type:Organization
Organization Name:EVOLUTION HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:TARAK
Authorized Official - Middle Name:N
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-390-2402
Mailing Address - Street 1:520 GREENHILL AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-1851
Mailing Address - Country:US
Mailing Address - Phone:302-390-2402
Mailing Address - Fax:
Practice Address - Street 1:9 E LOOCKERMAN ST STE 3A
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-7316
Practice Address - Country:US
Practice Address - Phone:302-394-6214
Practice Address - Fax:302-394-6213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-07
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty