Provider Demographics
NPI:1760114151
Name:SPAHR, EVAN JACOB (PT, DPT, OCS)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:JACOB
Last Name:SPAHR
Suffix:
Gender:M
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7825 BALLANTYNE COMMONS PKWY STE 210
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-3729
Mailing Address - Country:US
Mailing Address - Phone:704-446-7040
Mailing Address - Fax:
Practice Address - Street 1:7825 BALLANTYNE COMMONS PKWY STE 210
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-3729
Practice Address - Country:US
Practice Address - Phone:704-446-7040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-26
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist