# MR. ANDREW BRIAN DAVIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1780627083
- **Gender:** Man
- **Credential:** MSPT LAT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 9563-24 | WI | Yes |
| 225100000X | Physical Therapist | 9563024 | WI | — |
| 2255A2300X | Athletic Trainer | 279039 | WI | — |

## Other

- **Enumeration date:** 06/14/2006
- **Last updated:** 12/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 41810500 | — | WI |
| 01 | — | 69530 | SECURITY HEALTH | WI |