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General NPI Number Information
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NPI Number | 1457499709
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Entity Type | Individual
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Provider Name | DANIEL TODD DAVIS OTR/L
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Gender | Male
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 03/30/2015
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Provider Practice Location Address
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Address Line | 2300 PAVILION DR
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City | KINGSPORT
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State | TN
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Zip | 37660-4622
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Country | US
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Telephone | 423-765-9655
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Fax | 423-392-4795
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Provider Business Mailing Address
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Address Line | 2300 PAVILION DR
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City | KINGSPORT
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State | TN
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Zip | 37660-4622
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Country | US
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Telephone | 423-765-9655
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Fax | 423-392-4795
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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 | 101Y00000X
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Taxonomy Name | Counselor
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5137
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License Number State | TN
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