Individual
NOAH MIKAEL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
600 LINCOLN AVE, CHARLESTON, IL 61920-3099
(618) 554-8410
Mailing address
2020 10TH ST APT 102, CHARLESTON, IL 61920-3436
(618) 554-8410
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
05/08/2025
Last updated
05/08/2025
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