Individual
MRS. CAMELLIA S DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9850 ST LUKES DR, NAMPA, ID 83687-7912
(208) 505-2000
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(307) 421-5057
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5027
ID
Other
Enumeration date
08/07/2017
Last updated
07/21/2022
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