Individual
TRELLA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
260 IROQUOIS, LYONS, CO 80540-8277
(620) 214-3693
Mailing address
260 IROQUOIS, LYONS, CO 80540-8277
(620) 214-3693
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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