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General NPI Number Information
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NPI Number | 1396920815
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Entity Type | Individual
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Provider Name | SUSAN DAVIS L.AC.
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Gender | Female
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 01/03/2008
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Provider Practice Location Address
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Address Line | 4600 CONNECTICUT AVE NW STE 223
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City | WASHINGTON
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State | DC
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Zip | 20008-5702
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Country | US
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Telephone | 202-244-8824
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Fax |
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Provider Business Mailing Address
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Address Line | 7106 WOODLAND AVE
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City | TAKOMA PARK
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State | MD
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Zip | 20912-4565
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Country | US
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Telephone | 301-275-0165
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC24
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | U284
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License Number State | MD
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