Provider Demographics
NPI:1861941429
Name:EVANS, OLIVER RAYMOND II (DC)
Entity type:Individual
Prefix:DR
First Name:OLIVER
Middle Name:RAYMOND
Last Name:EVANS
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 HICKORY RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30115-9600
Mailing Address - Country:US
Mailing Address - Phone:670-880-6616
Mailing Address - Fax:678-881-6617
Practice Address - Street 1:120 HICKORY RD
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30115-9600
Practice Address - Country:US
Practice Address - Phone:670-880-6616
Practice Address - Fax:678-881-6617
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-23
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009722111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor