Individual
COLTON DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
32 MILLBRANCH RD STE 40, HATTIESBURG, MS 39402
(601) 255-5264
(866) 625-0559
Mailing address
32 MILLBRANCH RD STE 40, HATTIESBURG, MS 39402-3227
(601) 255-5264
(866) 625-0559
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-230403
MS
Other
Enumeration date
09/14/2020
Last updated
08/19/2022
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