Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT007253L | PA |
NPI | 1598298929 |
---|---|
Provider Name | Dr. Carol Ann Davidson |
First Address | Philadelphia, PA 19119-3306 |
Second Address | Philadelphia, PA 19119-3306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2017 |
Last Update Date | 04/04/2017 |