Individual
REBECCA DIANE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
701 S. 19TH ST, LHR 112, BIRMINGHAM, AL 35233
(205) 934-5526
Mailing address
PO BOX 333, CARBON HILL, AL 35549-0333
(313) 268-1453
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1647
AL
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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