Individual
TRACY KYLE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTA/L
Contact information
Practice address
213 WILSON MANN RD, OWENS CROSS ROADS, AL 35763-8606
(256) 725-3400
Mailing address
204 STEWART ST SW, HARTSELLE, AL 35640-2920
(256) 754-4456
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3391
AL
Other
Enumeration date
01/25/2019
Last updated
01/25/2019
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