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Individual

DAVID DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, OCS

Contact information

Practice address
1950 BLUEWATER BLVD, SUITE 101, NICEVILLE, FL 32578-3887
(850) 897-3334
(850) 897-7855
Mailing address
1950 BLUEWATER BLVD, SUITE 101, NICEVILLE, FL 32578-3887
(850) 897-3334
(850) 897-7855

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT17177
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
Y906W
GROUP
FL
Enumeration date
08/09/2006
Last updated
07/09/2007
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