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Individual

CAROL DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
700 1ST DR NW, AUSTIN, MN 55912-3095
(763) 689-5385
Mailing address
87892 225TH ST, OAKLAND, MN 56007-7682

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101449
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6403339
MEDICA
MN
01
8G688DA
BLUE CROSS BLUE SHIELD
MN
01
HP45725
HEALTH PARTNERS
MN
Enumeration date
09/26/2006
Last updated
07/09/2007
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