Individual
TAMMY DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14 FORT TOWN DR, FORT OGLETHORPE, GA 30742-4051
(423) 902-1738
Mailing address
73 AUSTIN CIR, ROSSVILLE, GA 30741-3577
(423) 902-1738
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001780
GA
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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