Organization
CDM BOXING ASSOCIATION
Active
Organization
CDM BOXING ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FELICIA DAVIS-DARTHARD M.S. (ADMINISTRATOR)
(404) 610-3046
Entity
Organization
Contact information
Practice address
1007 STABLE SIDE CT, HOUSTON, TX 77073-6409
(404) 610-3046
(281) 443-1432
Mailing address
1007 STABLE SIDE CT, HOUSTON, TX 77073-6409
(404) 610-3046
(281) 443-1432
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
224Y00000X
Clinical Exercise Physiologist
—
—
2251S0007X
Sports Physical Therapist
—
—
2255A2300X
Athletic Trainer
—
—
225800000X
Recreation Therapist
—
—
226300000X
Kinesiotherapist
—
—
Other
Enumeration date
11/23/2011
Last updated
09/12/2016
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