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General NPI Number Information
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NPI Number | 1548949266
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Entity Type | Individual
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Provider Name | CHRISTIAN DAVIS
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Gender | Female
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 3107 W CAMP WISDOM RD STE 131
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City | DALLAS
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State | TX
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Zip | 75237-2600
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Country | US
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Telephone | 214-339-4533
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Fax |
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Provider Business Mailing Address
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Address Line | 655 S WILLOW ST STE 128
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City | MANCHESTER
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State | NH
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Zip | 03103-5723
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Country | US
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Telephone |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 11194
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 005033
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2176005
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License Number State | TX
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