Individual
JONATHAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
21 ELTON DR, NEWINGTON, CT 06111-2606
(860) 388-7282
Mailing address
21 ELTON DR, NEWINGTON, CT 06111-2606
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/18/2020
Last updated
05/18/2020
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