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General NPI Number Information
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NPI Number | 1366730335
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Entity Type | Organization
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Legal Business Name | DR JONATHAN B DAVIS PC
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 07/12/2011
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Provider Practice Location Address
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Address Line | 16005 COMPRINT CIR
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City | GAITHERSBURG
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State | MD
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Zip | 20877-1318
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Country | US
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Telephone | 301-963-6700
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Fax | 301-670-0306
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Provider Business Mailing Address
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Address Line | 16005 COMPRINT CIR
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City | GAITHERSBURG
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State | MD
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Zip | 20877-1318
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Country | US
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Telephone | 301-963-6700
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Fax | 301-670-0306
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Authorized Official
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Title or Position | ASSISTANT
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Name | MR. ROBERT L CARSON
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Credential |
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Telephone | 240-252-4477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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