Individual
DEIDRE A.L DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 CHICAGO ST APT 2, GREEN BAY, WI 54301-3966
(920) 217-4266
Mailing address
800 CHICAGO ST APT 2, GREEN BAY, WI 54301-3966
(920) 217-4266
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/22/2024
Last updated
09/11/2025
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