Individual
GWENDOLYN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
993 E COLLEGE ST, PULASKI, TN 38478-4432
(931) 363-3572
Mailing address
570 SHADY LN, PULASKI, TN 38478-7402
(937) 459-2064
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4563
TN
Other
Enumeration date
02/07/2017
Last updated
02/07/2017
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