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General NPI Number Information
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NPI Number | 1609752047
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Entity Type | Organization
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Legal Business Name | DAVIS SPINE AND SPORT RECOVERY LLC
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 314 BILLY DYAR BLVD APT 4
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City | BOAZ
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State | AL
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Zip | 35957-2217
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Country | US
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Telephone | 256-907-9561
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Fax | 256-907-9435
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Provider Business Mailing Address
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Address Line | 314 BILLY DYAR BLVD APT 4
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City | BOAZ
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State | AL
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Zip | 35957-2217
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Country | US
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Telephone | 256-907-9561
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Fax | 256-907-9435
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Authorized Official
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Title or Position | OWNER
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Name | DR. CONNOR LEE DAVIS
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Credential |
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Telephone | 256-907-9561
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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 |
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License Number State |
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