Basic Information
| Provider Information | |||||||||
| NPI: | 1154588747 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEVOS | ||||||||
| FirstName: | ELAINE | ||||||||
| MiddleName: | L | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 39 | ||||||||
| Address2: | |||||||||
| City: | MOREHEAD CITY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285570039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002280249 | ||||||||
| FaxNumber: | 2522223602 | ||||||||
| Practice Location | |||||||||
| Address1: | 2511 WESLEY ST | ||||||||
| Address2: | |||||||||
| City: | JOHNSON CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376011723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002280249 | ||||||||
| FaxNumber: | 2522223602 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2008 | ||||||||
| LastUpdateDate: | 05/21/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | MD28462 | TN | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.