Individual
JOSHUA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
629 MAIN ST, SOUTH PORTLAND, ME 04106-5415
(207) 592-0884
Mailing address
629 MAIN ST, SOUTH PORTLAND, ME 04106-5415
(207) 592-0884
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT4617
ME
Other
Enumeration date
10/20/2012
Last updated
02/17/2015
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