Healthcare Provider Details

I. General information

NPI: 1083520068
Provider Name (Legal Business Name): KA'LEAH JANAE DAVIS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 S 9TH ST STE A
GRIFFIN GA
30224-4216
US

IV. Provider business mailing address

680 S 9TH ST STE A
GRIFFIN GA
30224-4216
US

V. Phone/Fax

Practice location:
  • Phone: 770-229-6141
  • Fax: 770-229-6142
Mailing address:
  • Phone: 770-229-6141
  • Fax: 770-229-6142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT018525
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: