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General NPI Number Information
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NPI Number | 1396346169
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Entity Type | Individual
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Provider Name | DEBRA DAVIS LMT
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Gender | Female
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Dates
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Enumeration Date | 11/06/2020
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 702 BALDWIN DR STE A
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City | ALBANY
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State | GA
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Zip | 31707-4027
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Country | US
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Telephone | 229-310-0862
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Fax |
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Provider Business Mailing Address
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Address Line | 207 CHESTNUT STR
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City | COLEMAN
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State | GA
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Zip | 39836
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Country | US
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Telephone | 229-310-0862
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT011126
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License Number State | GA
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