Individual
THERESA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2963 DODDRIDGE AVE, MARYLAND HEIGHTS, MO 63043-1736
(314) 291-4557
Mailing address
1073 ROTH AVE, SAINT LOUIS, MO 63130-2542
(314) 267-2165
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2017036512
MO
Other
Enumeration date
10/24/2021
Last updated
10/24/2021
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