Individual
DARCI DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
36 WINN DR, REXBURG, ID 83440-5277
(208) 356-0174
(208) 356-0176
Mailing address
36 WINN DR, REXBURG, ID 83440-5277
(208) 356-0174
(208) 356-0176
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-4539
ID
Other
Enumeration date
08/05/2016
Last updated
08/05/2016
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