MEDICARE: MRS. NAN F DAVISON LMT

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
1	225700000X	Massage Therapist	0019008765	VA

General Provider Information

NPI Number	:	1942999289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NAN F DAVISON LMT

Provider Business Mailing Address
First Line	:	3405 FIDDLERS GRN
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-1240
Country	:	US
Telephone Number	:	202-374-1850
Fax Number	:

Provider Business Practice Location Address
First Line	:	2250 CLARENDON BLVD STE K
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-3349
Country	:	US
Telephone Number	:	202-374-1850
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2023
Last Update Date	:	05/03/2023

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