Individual
TODD DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2342 AVENIDA DEL VIS, CORONA, CA 92882-5657
(951) 642-4394
Mailing address
2342 AVENIDA DEL VIS, CORONA, CA 92882-5657
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
060002468
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C7036284
CA
CA
Enumeration date
01/11/2020
Last updated
01/11/2020
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