Individual
KEIZIA DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAC
Contact information
Practice address
153 RIPON CT, RIDGELAND, MS 39157-1265
(601) 624-5953
Mailing address
153 RIPON CT, RIDGELAND, MS 39157-1265
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0965
MS
Other
Enumeration date
12/24/2019
Last updated
12/24/2019
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