Individual
TIMOTHEA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
921 GREGORY AVE, BEDFORD, TX 76022-7844
(817) 880-5847
Mailing address
921 GREGORY AVE, BEDFORD, TX 76022-7844
(817) 880-5847
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT115275
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT115275
TEXAS DEPARTMENT OF LICENSING AND REGULATION
TX
Enumeration date
04/27/2020
Last updated
04/27/2020
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