Individual
MR. ANDREW BRIAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT LAT
Contact information
Practice address
225000 HUMMINGBIRD RD STE 100, WAUSAU, WI 54401-2950
(715) 359-6442
Mailing address
225000 HUMMINGBIRD RD STE 100, WAUSAU, WI 54401-2950
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9563-24
WI
225100000X
Physical Therapist
9563024
WI
2255A2300X
Athletic Trainer
279039
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41810500
—
WI
01
—
69530
SECURITY HEALTH
WI
Enumeration date
06/14/2006
Last updated
12/07/2023
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