Individual
RYAN T DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
103 E LINCOLN ST, UNIT G, NORMAL, IL 61761-1442
(217) 620-3890
Mailing address
103 E LINCOLN ST, UNIT G, NORMAL, IL 61761-1442
(217) 620-3890
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096002688
IL
Other
Enumeration date
01/15/2009
Last updated
06/18/2015
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