Individual
JORDAN DAVIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8746 ERIE RD STE A, ANGOLA, NY 14006-9620
(716) 549-4999
Mailing address
616 MOORE RD, FREEDOM, NY 14065-9764
(716) 353-2395
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
010572
NY
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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