Healthcare Provider Details

I. General information

NPI: 1407743545
Provider Name (Legal Business Name): CHARLES LEE BARRETT DAVIS RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 DESALES AVE
CHATTANOOGA TN
37404-1161
US

IV. Provider business mailing address

257 E PLANTATION ST
CHATSWORTH GA
30705-6279
US

V. Phone/Fax

Practice location:
  • Phone: 423-495-2525
  • Fax:
Mailing address:
  • Phone: 706-428-1924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number9358
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number13934
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: