Individual
BRIAN WAYNE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
20 W FRAZIER ST, SMYRNA, DE 19977-1416
(302) 653-2758
Mailing address
215 PITCH KETTLE CT, MAGNOLIA, DE 19962-1592
(302) 236-7310
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
U2-0000204
DE
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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