Individual
THANIEL EARL DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14328 FALCO AVE, NORWALK, CA 90650-5012
(156) 244-0807
Mailing address
14328 FALCO AVE, NORWALK, CA 90650-5012
(562) 440-8079
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
—
—
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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