Individual
SALLY JEAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1201 HOLLAND LAKE DR, WEATHERFORD, TX 76086-5851
(817) 598-0162
Mailing address
2813 WEBER ST, FORT WORTH, TX 76106-7340
(817) 223-9544
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
109461
TX
Other
Enumeration date
08/29/2018
Last updated
08/29/2018
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