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General NPI Number Information
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NPI Number | 1154920460
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Entity Type | Individual
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Provider Name | KATHLEEN PATRICIA DAVIS PT, DPT, ATC
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Gender | Female
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Dates
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Enumeration Date | 10/19/2020
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 130 BUSINESS PARK DR
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City | ARMONK
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State | NY
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Zip | 10504-1727
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Country | US
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Telephone | 914-273-3414
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Fax |
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Provider Business Mailing Address
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Address Line | 35 SUTHERLAND DR
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City | HIGHLAND MILLS
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State | NY
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Zip | 10930-3011
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Country | US
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Telephone |
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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 | 046462
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License Number State | NY
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