Individual
MR. BENJAMIN DREW DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1200 MAGNOLIA WAY, BLUE SPRINGS, MS 38828-6000
(662) 317-3229
(662) 317-3216
Mailing address
2804 CONFEDERATE AVE, TUPELO, MS 38801-4104
(662) 397-4415
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000018226
MS
Other
Enumeration date
03/14/2018
Last updated
03/14/2018
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