Individual
SIAH DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
718 LONG ISLAND AVE, DEER PARK, NY 11729-4230
(718) 554-1042
Mailing address
718 LONG ISLAND AVE, DEER PARK, NY 11729-4230
(718) 554-1042
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
10/05/2018
Last updated
11/13/2018
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