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NPI Code Detail

MEDICARE: MELISSA B DAVIS OTR

MEDICARE:   MELISSA B DAVIS  OTR
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
1225X00000XOccupational TherapistOTT.Z10913LA

General Provider Information

NPI Number : 1639768880
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA B DAVIS OTR
Provider Business Mailing Address
First Line : 401 S GAYLE AVE
Second Line :
City : BUNKIE
State : LA
Zip : 71322-2223
Country : US
Telephone Number : 770-815-0877
Fax Number :
Provider Business Practice Location Address
First Line : 1123 SHIRLEY RD
Second Line :
City : BUNKIE
State : LA
Zip : 71322-1553
Country : US
Telephone Number : 318-346-3312
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2021
Last Update Date : 01/12/2021

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Directions to “ MELISSA B DAVIS OTR” Practice Location

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