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NPI Code Detail

MEDICARE: COURTNEY DAVIS PT

MEDICARE: COURTNEY DAVIS PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist9200GA

General Provider Information

NPI Number : 1275722282
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY DAVIS PT
Provider Business Mailing Address
First Line : 6135 ROOSEVELT HWY
Second Line :
City : WARM SPRINGS
State : GA
Zip : 31830
Country : US
Telephone Number : 706-655-5636
Fax Number : 706-655-5661
Provider Business Practice Location Address
First Line : 6135 ROOSEVELT HWY
Second Line :
City : WARM SPRINGS
State : GA
Zip : 31830-2281
Country : US
Telephone Number : 706-655-5636
Fax Number : 706-655-5661
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2007
Last Update Date : 10/16/2007

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