Individual
MS. JILL DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.R.
Contact information
Practice address
222 W 83RD ST, #5C, NEW YORK, NY 10024-4909
(212) 580-4275
Mailing address
222 WEST 83RD STREET, #5C, NY, NY 10024
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
012918-1
NY
174400000X
Specialist
012918-1
NY
Other
Enumeration date
11/25/2008
Last updated
11/25/2008
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