Doctor Name: | KELLIE S DAVIDSON |
NPI Number: | 1245554864 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2004023000 |
Business Practice Address: | 420 S Fulton St Butler, MO - 647302058 |
Business Phone Number: | 6606790653 |
Business Fax Number: | 6602003010 |
Mailing Address: | 420 S Fulton St, BUTLER |
State: | MO |
Postal Code: | 647302058 |
Phone Number: | 6606790653 |
Fax Number: | 6602003010 |
NPI Enumeration Date: | 03/25/2010 |
NPI Last Update Date: | 03/25/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 2004023000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |