Most Relevant Information
Provider Data
| NPI Number: | 1003562869 |
| Provider Name: | EVAN GANICK |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 115656 |
Most Important Dates
| Enumeration Date: | 03/01/2022 |
| Last Updated: | 03/01/2022 |
Provider Practice Location
89 OUCHONDER RD
ELMWOOD
TN
385604232
Practice Location Phone/Fax
| Phone: | 6155796241 |
| Fax: |
Provider Mailing Location
89 OUCHONDER RD
ELMWOOD
TN
385604232
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |