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Individual

MR. DONNIE BRITTEN DAVIS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
52 GLOSTER CT, MALVERN, AR 72104-3900
(501) 420-4491
Mailing address
52 GLOSTER CT, MALVERN, AR 72104-3900
(501) 420-4491

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT 364
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AT 364
ATHLETIC TRAINER
AR
Enumeration date
07/03/2006
Last updated
06/16/2012
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