Individual
NICOLE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
75 HALE ST, WILMINGTON, OH 45177-2104
(937) 382-1621
Mailing address
1848 CENTER RD, WILMINGTON, OH 45177-8378
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA04491
OH
Other
Enumeration date
04/14/2015
Last updated
02/15/2019
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