Individual
MARK RANDALL DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1437 6TH STREET CIR NW, HICKORY, NC 28601-5255
(828) 327-5531
Mailing address
1437 6TH STREET CIR NW, HICKORY, NC 28601-5255
(828) 327-5531
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1548
NC
Other
Enumeration date
06/20/2016
Last updated
06/20/2016
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