Individual
MICHELLE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4739
(662) 772-4972
Mailing address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4739
(662) 772-4972
Taxonomy
Speciality
Code
Description
License number
State
2279C0205X
Critical Care Registered Respiratory Therapist
RCP 4920
MS
2279C0205X
Critical Care Registered Respiratory Therapist
Primary
RRT 5870
TN
Other
Enumeration date
08/17/2014
Last updated
08/17/2014
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