Individual
LENA EVELYN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT, MS
Contact information
Practice address
5037 RIVER ROCK WAY, WOODSTOCK, GA 30188-2994
(770) 789-0192
Mailing address
5037 RIVER ROCK WAY, WOODSTOCK, GA 30188-2994
(770) 789-0192
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002942
GA
Other
Enumeration date
12/19/2020
Last updated
12/19/2020
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