Individual
JEFFREY SAMUEL DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., ATP
Contact information
Practice address
1357 SELBYDON WAY, WINTER GARDEN, FL 34787-4652
(352) 536-4981
Mailing address
1357 SELBYDON WAY, WINTER GARDEN, FL 34787-4652
(352) 536-4981
Taxonomy
Speciality
Code
Description
License number
State
225CA2400X
Assistive Technology Practitioner Rehabilitation Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018669400
—
FL
Enumeration date
03/07/2017
Last updated
06/19/2021
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