Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 33635 | CA |
Y | 111NS0005X | Chiropractic Sports Physician | 3473 | TN |
NPI | 1356658264 |
---|---|
Provider Name | Dr. Garet S Davis |
First Address | Franklin, TN 37067-1763 |
Second Address | Alta Loma, CA 91701-5822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2010 |
Last Update Date | 07/12/2021 |