Individual
MR. ANTONIO LA DON DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
820 1/2 S KNOBLOCK ST, STILLWATER, OK 74074-4528
(757) 289-6466
Mailing address
820 1/2 S KNOBLOCK ST, STILLWATER, OK 74074-4528
(757) 289-6466
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
731
OK
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/14/2019
Last updated
01/14/2019
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