Provider Demographics
NPI:1184826216
Name:BEVANS, TREVOR L (DC)
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:L
Last Name:BEVANS
Suffix:
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 1:36 SCHOOL STREET
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530
Mailing Address - Country:US
Mailing Address - Phone:207-443-2635
Mailing Address - Fax:207-443-1244
Practice Address - Street 1:36 SCHOOL STREET
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530
Practice Address - Country:US
Practice Address - Phone:207-443-2635
Practice Address - Fax:207-443-1244
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1749111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor