Individual
MS. BRENDA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ORT
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
04-0222
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-0222
CERT ORTHOPAEDIC TECH
CA
Enumeration date
03/07/2007
Last updated
07/08/2007
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