Individual
ANDREW WILLIAM DAVIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 993-4131
Mailing address
16450 NEW DENNISON RD, MARION, IL 62959-6259
(618) 694-6870
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057001941
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057001941
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
02/24/2023
Last updated
02/24/2023
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