Individual
HAILEY MARIE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
36 WINN DR STE 100, REXBURG, ID 83440-5277
(208) 356-0174
Mailing address
36 WINN DR STE 100, REXBURG, ID 83440-5277
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-6792
ID
Other
Enumeration date
02/20/2020
Last updated
02/20/2020
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