Individual
SAMANTHA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
286 ROSE ST, BELLEVILLE, WI 53508-9207
(608) 843-2483
Mailing address
1018 PINE ST, SUN PRAIRIE, WI 53590-1139
(608) 279-9322
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5779 - 26
WI
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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