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NPI Code Detail

MEDICARE: BRITTANI ALYSE DAVIS MT

MEDICARE:   BRITTANI ALYSE DAVIS  MT
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 TherapistNVMT.11143NV

General Provider Information

NPI Number : 1053074088
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANI ALYSE DAVIS MT
Provider Business Mailing Address
First Line : 2710 CORAL CLIFFS CT
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-0681
Country : US
Telephone Number : 702-444-6715
Fax Number :
Provider Business Practice Location Address
First Line : 2710 CORAL CLIFFS CT
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-0681
Country : US
Telephone Number : 702-444-6715
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2021
Last Update Date : 10/17/2021

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Directions to “ BRITTANI ALYSE DAVIS MT” Practice Location

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