Individual
JENNIFER DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
100 BUTLER DR, PROVIDENCE, RI 02906-4862
(401) 330-1428
(401) 626-3851
Mailing address
PO BOX 1119, PROVIDENCE, RI 02901-1119
(401) 330-1428
(401) 626-3851
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT01657
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
409035
BLUECHIP RI IND. ID #
RI
Enumeration date
05/16/2006
Last updated
06/21/2016
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