Individual
KELLIE S DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
420 S FULTON ST, BUTLER, MO 64730-2058
(660) 679-0653
(660) 200-3010
Mailing address
420 S FULTON ST, BUTLER, MO 64730-2058
(660) 679-0653
(660) 200-3010
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2004023000
MO
Other
Enumeration date
03/25/2010
Last updated
03/25/2010
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