Individual
BRYAN DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3902 NEW HOLLAND DR, WILMINGTON, NC 28412-5103
(910) 386-9300
Mailing address
3902 NEW HOLLAND DR, WILMINGTON, NC 28412-5103
(910) 386-9300
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
9859
NC
Other
Enumeration date
12/12/2016
Last updated
12/12/2016
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