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NPI Code Detail

MEDICARE: DREW DAVIS LMT

MEDICARE: DREW DAVIS LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist33.024595OH

General Provider Information

NPI Number : 1023604345
Entity Type Code : Individual
Provider Name (Legal Business Name) : DREW DAVIS LMT
Provider Business Mailing Address
First Line : 39000 MENTOR AVE
Second Line :
City : WILLOUGHBY
State : OH
Zip : 44094-8095
Country : US
Telephone Number : 440-953-3950
Fax Number :
Provider Business Practice Location Address
First Line : 39000 MENTOR AVE
Second Line :
City : WILLOUGHBY
State : OH
Zip : 44094-8095
Country : US
Telephone Number : 440-953-3950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2020
Last Update Date : 12/21/2020

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Directions to “ DREW DAVIS LMT” Practice Location

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