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General NPI Number Information
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NPI Number | 1659785525
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Entity Type | Individual
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Provider Name | HEATHER CATHERINE DAVIS DC
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Gender | Female
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 10/26/2016
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Provider Practice Location Address
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Address Line | 13 S NATIONAL AVE
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City | FORT SCOTT
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State | KS
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Zip | 66701-1308
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Country | US
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Telephone | 620-200-4872
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Fax | 620-223-1445
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Provider Business Mailing Address
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Address Line | 863 195TH ST
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City | FORT SCOTT
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State | KS
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Zip | 66701-8790
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Country | US
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Telephone | 620-200-4872
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Fax | 620-223-1445
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2014016555
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License Number State | MO
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