Individual
RUSSELL EMMETT DAVIS III
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1341 MEDICAL PARK DR, MELBOURNE, FL 32901-3235
(321) 728-7418
(321) 728-7403
Mailing address
108 TEQUESTA HARBOR DR, MERRITT ISLAND, FL 32952-7107
(321) 449-0894
(321) 449-0894
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
OT7148
FL
Other
Enumeration date
03/25/2006
Last updated
07/08/2007
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