Individual
JACLYN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, LMT
Contact information
Practice address
932 N WRIGHT ST STE 160, NAPERVILLE, IL 60563-3601
(630) 508-0223
Mailing address
216 N BROADVIEW AVE, LOMBARD, IL 60148-1521
(630) 508-0223
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
160.006497
IL
225700000X
Massage Therapist
Primary
227007638
IL
225700000X
Massage Therapist
60668567
WA
Other
Enumeration date
08/14/2013
Last updated
09/10/2023
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