Individual
NICOLE L DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
240 MAPLE STREET, WOODRUFF, WI 54568-0470
(715) 356-8000
Mailing address
240 MAPLE STREET, PO BOX 470, WOODRUFF, WI 54568-0470
(715) 356-8000
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
521-039
WI
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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