Individual
JEB CULHAM DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
837 OSO GRANDE DR, DURANGO, CO 81301-6599
(505) 948-6976
Mailing address
837 OSO GRANDE DR, DURANGO, CO 81301-6599
(505) 948-6976
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
290
NM
Other
Enumeration date
05/02/2007
Last updated
02/22/2015
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