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Individual

KEMOY DAVIDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAT, ATC, NREMT

Contact information

Practice address
300 POMPTON RD, WAYNE, NJ 07470-2103
(973) 720-2000
Mailing address
35 E TRYON AVE APT 16, TEANECK, NJ 07666-6154
(201) 530-5064

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
641258
NJ
2255A2300X
Athletic Trainer
Primary
25MT00283300
NJ

Other

Enumeration date
02/09/2021
Last updated
02/27/2021
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