Individual
JOHN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
1800 S 4TH ST, JACOBSON BUILDING, AMES, IA 50011-1142
(515) 294-6315
Mailing address
117 NE 46TH LN UNIT 4, ANKENY, IA 50021-8115
(949) 374-1691
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
079840
IA
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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