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General NPI Number Information
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NPI Number | 1407398605
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Entity Type | Individual
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Provider Name | TRAVIS DALE DAVIS DPT
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Gender | Male
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Dates
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Enumeration Date | 11/06/2016
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 1515 W CENTER ST
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City | GREENWOOD
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State | AR
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Zip | 72936-3423
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Country | US
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Telephone | 479-252-1989
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Fax |
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Provider Business Mailing Address
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Address Line | 116 STAFFORDSHIRE DRIVE
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City | STATESVILLE
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State | NC
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Zip | 28625
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Country | US
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Telephone | 479-252-1989
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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 | 1276171
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P17776
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 4129
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License Number State | AR
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