Individual
MARY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3531 FOREST HILL AVE NW, ROANOKE, VA 24012-3945
(540) 343-3484
Mailing address
3531 FOREST HILL AVE NW, ROANOKE, VA 24012-3945
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602530
VA
Other
Enumeration date
05/15/2009
Last updated
05/15/2009
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