MEDICARE: MRS. BARBARA L. DAVIDSON R.D.

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
1	133V00000X	Registered Dietitian	DN005020	PA

General Provider Information

NPI Number	:	1639561541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BARBARA L. DAVIDSON R.D.

Provider Business Mailing Address
First Line	:	2156 FERNCROFT LN
Second Line	:
City	:	CHESTER SPRINGS
State	:	PA
Zip	:	19425-3846
Country	:	US
Telephone Number	:	484-354-2902
Fax Number	:

Provider Business Practice Location Address
First Line	:	2156 FERNCROFT LN
Second Line	:
City	:	CHESTER SPRINGS
State	:	PA
Zip	:	19425-3846
Country	:	US
Telephone Number	:	484-354-2902
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2015
Last Update Date	:	03/02/2015

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