Healthcare Provider Details

I. General information

NPI: 1952956153
Provider Name (Legal Business Name): KERI J DAVIS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2019
Last Update Date: 08/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35095 US 19 N STE 101
PALM HARBOR FL
34684-1968
US

IV. Provider business mailing address

21756 SR 54 102
LUTZ FL
33549
US

V. Phone/Fax

Practice location:
  • Phone: 727-475-5538
  • Fax: 844-213-8986
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT34877
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: