Individual
MS. KATHY J. DAVIS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHD, ATC, CSCS
Contact information
Practice address
77 MASSACHUSETTS AVE, W35-115, CAMBRIDGE, MA 02139-4301
(617) 253-4908
Mailing address
16 PAUL AVE, DERRY, NH 03038-3803
(603) 425-6335
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
11
MA
2255A2300X
Athletic Trainer
8
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255A2300X
ATHLETIC TRAINING SERVICE
MA
Enumeration date
10/10/2005
Last updated
07/08/2007
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