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General NPI Number Information
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NPI Number | 1477062081
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Entity Type | Individual
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Provider Name | NICK DAVIS
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Gender | Male
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 09/26/2017
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Provider Practice Location Address
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Address Line | 2800 10TH AVE N
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City | BILLINGS
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State | MT
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Zip | 59101-0703
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Country | US
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Telephone | 406-657-4880
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Fax |
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Provider Business Mailing Address
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Address Line | 2901 MONAD RD APT 28
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City | BILLINGS
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State | MT
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Zip | 59102-6106
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Country | US
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Telephone | 406-396-6079
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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 | 7676
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License Number State | MT
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