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General NPI Number Information
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NPI Number | 1508087404
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Entity Type | Organization
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Legal Business Name | DAVIS CHIROPRACTIC LLC
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 311 S ALLEN ST STE. 3
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City | STATE COLLEGE
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State | PA
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Zip | 16801-4857
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Country | US
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Telephone | 814-441-4484
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Fax | 814-234-0395
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Provider Business Mailing Address
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Address Line | 213 GHANER DR
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City | STATE COLLEGE
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State | PA
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Zip | 16803-1172
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Country | US
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Telephone | 814-441-4484
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Fax | 814-234-0395
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUZANNE DAVIS
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Credential | DC
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Telephone | 814-441-4484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC009250
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License Number State | PA
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