Individual
MS. DEBORAH DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
3605 COLLEGE AVE, CONWAY, AR 72034
(501) 327-2235
(501) 327-1601
Mailing address
3605 COLLEGE AVE, CONWAY, AR 72034
(501) 327-2235
(501) 327-1601
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT964
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184657721
—
AR
01
—
5S399
BCBS
AR
01
—
710857801
QUALCHOICE
AR
01
—
A002
TRICARE
AR
01
—
P01546505
PALMETTO RR
AR
Enumeration date
05/25/2006
Last updated
12/16/2015
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