Individual
ANITA DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
222 S GREENLEAF ST, SUITE 101, GURNEE, IL 60031-5705
(847) 599-9171
Mailing address
4835 KINGS WAY W, GURNEE, IL 60031-3257
(847) 599-9171
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070004540
IL
Other
Enumeration date
08/25/2010
Last updated
08/25/2010
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