Healthcare Provider Details

I. General information

NPI: 1386657898
Provider Name (Legal Business Name): KATHYRN S DAVIS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 HARRINGTON HWY
EDEN NC
27288-7547
US

IV. Provider business mailing address

2426 NARROW GAUGE RD
REIDSVILLE NC
27320-7717
US

V. Phone/Fax

Practice location:
  • Phone: 336-627-7547
  • Fax: 336-627-2660
Mailing address:
  • Phone: 336-349-4702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1997
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: