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General NPI Number Information
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NPI Number | 1851416507
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Entity Type | Individual
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Provider Name | ANGELA DAVIS P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 16000 JOHNSTON MEMORIAL DR STE 100
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City | ABINGDON
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State | VA
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Zip | 24211-7664
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Country | US
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Telephone | 276-477-1443
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Fax |
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Provider Business Mailing Address
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Address Line | 4105 FORT HENRY DR STE 300
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City | KINGSPORT
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State | TN
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Zip | 37663-2256
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Country | US
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Telephone | 423-239-1550
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305003090
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License Number State | VA
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