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Individual

HAYLEY M DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
5006 COPPER AVE NE, ALBUQUERQUE, NM 87108-1301
(505) 268-7988
(505) 268-8021
Mailing address
317 CORNELL DR SE, ALBUQUERQUE, NM 87106-3584
(505) 301-4477

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
4372
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10171568
NM
01
326556
MEDICARE
NM
Enumeration date
09/04/2013
Last updated
09/04/2013
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