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General NPI Number Information
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NPI Number | 1114651734
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Entity Type | Individual
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Provider Name | MICHELLE DAVIS DPT
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Gender | Female
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Dates
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Enumeration Date | 07/11/2022
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Last Update Date | 07/11/2022
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Provider Practice Location Address
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Address Line | 3141 CENTENNIAL BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-4094
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Country | US
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Telephone | 517-962-9223
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Fax |
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Provider Business Mailing Address
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Address Line | 2605 HEMLOCK BEACH DR
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City | READING
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State | MI
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Zip | 49274-8628
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Country | US
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Telephone | 517-962-9223
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P20481
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License Number State | NC
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