Individual
MR. BRIAN ROBERT DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
253 6TH AVE, SAINT JAMES, NY 11780-2707
(631) 584-0103
Mailing address
253 6TH AVE, SAINT JAMES, NY 11780-2707
(631) 584-0103
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
009384-1
NY
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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