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General NPI Number Information
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NPI Number | 1528475662
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Entity Type | Individual
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Provider Name | ERIKA RENEE DAVIS MS, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 07/21/2014
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Last Update Date | 12/19/2018
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Provider Practice Location Address
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Address Line | 1171 WHITLOCK AVE SW
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City | MARIETTA
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State | GA
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Zip | 30064-1932
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Country | US
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Telephone | 484-643-2169
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Fax |
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Provider Business Mailing Address
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Address Line | 1739 BROOKSTONE LN NW
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City | ACWORTH
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State | GA
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Zip | 30101-4560
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Country | US
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Telephone | 484-643-2169
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT003334
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RTO000181
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License Number State | PA
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