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General NPI Number Information
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NPI Number | 1689362824
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Entity Type | Individual
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Provider Name | CONOR MILEY DAVIS ATC
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Gender | Male
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Dates
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Enumeration Date | 04/26/2023
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Last Update Date | 04/26/2023
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Provider Practice Location Address
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Address Line | 800 CHUNG SHAN RD
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City | TAIPEI
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State | SHILIN
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Zip | 11152
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Country | TW
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Telephone | 206-549-9107
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Fax |
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Provider Business Mailing Address
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Address Line | 6501 LAKE WASHINGTON BLVD NE APT 202
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City | KIRKLAND
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State | WA
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Zip | 98033-3536
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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