Individual
ANDREA NICOLE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(276) 496-5265
Mailing address
205 EASY STR, SALTVILLE, VA 24370
(276) 496-5265
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3863
TN
Other
Enumeration date
12/12/2006
Last updated
07/08/2007
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