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Individual

MIKAELA DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4920 WOODMAR DR SW, ROANOKE, VA 24018-1651
(866) 450-4522
Mailing address
P.O. BOX 3155, ROANOKE, VA 24018
(540) 383-7549

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306604780
VA

Other

Enumeration date
07/20/2017
Last updated
07/21/2022
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