Individual
BRANDON THOMAS DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3800 INDEPENDENCE BLVD, WILMINGTON, NC 28412-2599
(910) 444-0513
Mailing address
806 MARCH CT APT D, WILMINGTON, NC 28405-3571
(910) 902-3167
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A6010
NC
Other
Enumeration date
08/14/2017
Last updated
08/14/2017
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