Individual
COLTON GRANT DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3964 GOODMAN RD E STE 111, SOUTHAVEN, MS 38672-8761
(662) 932-3844
(662) 393-8664
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
12890
TN
225100000X
Physical Therapist
Primary
PT7283
MS
Other
Enumeration date
06/25/2020
Last updated
09/20/2023
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