Individual
MS. JAYNE LEWIS DAVIDOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1335 LAKE CHARLES DR, ROSWELL, GA 30075-2849
(770) 587-0516
Mailing address
1335 LAKE CHARLES DR, ROSWELL, GA 30075-2849
(770) 587-0516
(770) 587-0516
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
PT000990
GA
Other
Enumeration date
06/21/2007
Last updated
07/08/2007
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