Individual
VAN H DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
11900 KANIS RD, STE D4, LITTLE ROCK, AR 72211
(501) 221-6009
(501) 801-1065
Mailing address
11900 KANIS RD, STE D4, LITTLE ROCK, AR 72211
(501) 221-6009
(501) 801-1065
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2200
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142776721
—
AR
05
—
154767742
—
AR
Enumeration date
08/16/2005
Last updated
09/03/2021
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