Individual
KYLE M. DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1020 GROVE RD, GREENVILLE, SC 29605-4649
(864) 455-2319
(864) 455-2340
Mailing address
255 ENTERPRISE BLVD, SUITE 250, GREENVILLE, SC 29615-6300
(864) 454-0888
(864) 454-1130
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5894
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202312101
TAX ID
SC
Enumeration date
02/02/2009
Last updated
02/02/2009
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