Individual
MISS JOANN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
255 GIBSON RD, EASLEY, SC 29640-7803
(864) 306-3383
Mailing address
255 GIBSON RD., EASLEY, SC 29640-7803
(864) 306-3383
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
2196
SC
Other
Enumeration date
04/24/2010
Last updated
04/24/2010
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