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NPI Code Detail

MEDICARE: DR. AMY DAWN DAVIS PT, DPT

MEDICARE: DR. AMY DAWN DAVIS PT, DPT
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 Therapist6130AZ
22251H1200XHand Physical Therapist6130AZ
32251X0800XOrthopedic Physical Therapist6130AZ

General Provider Information

NPI Number : 1871754697
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMY DAWN DAVIS PT, DPT
Provider Business Mailing Address
First Line : PO BOX 5274
Second Line :
City : LAKE MONTEZUMA
State : AZ
Zip : 86342-5274
Country : US
Telephone Number : 928-699-7938
Fax Number :
Provider Business Practice Location Address
First Line : 505 JACKS CANYON RD
Second Line :
City : SEDONA
State : AZ
Zip : 86351-7856
Country : US
Telephone Number : 928-284-2411
Fax Number : 928-284-2439
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2008
Last Update Date : 11/02/2015

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