Individual
NICOLE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1949 W RAY RD STE 23, CHANDLER, AZ 85224-4008
(480) 787-0638
Mailing address
125 S ALMA SCHOOL RD APT 1130, CHANDLER, AZ 85224-7611
(563) 742-1970
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
13106A
AZ
Other
Enumeration date
09/21/2017
Last updated
09/21/2017
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