Doctor Name: | JEROLD DAVIS |
NPI Number: | 1588773352 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 3313 Vollmer Rd Flossmoor, IL - 604222003 |
Business Phone Number: | 7089575304 |
Business Fax Number: | |
Mailing Address: | 612 Lilas Ct, NEW LENOX |
State: | IL |
Postal Code: | 604513453 |
Phone Number: | 8154631871 |
Fax Number: | |
NPI Enumeration Date: | 08/29/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |