Vincy Davis

Individual provider Active NPI Physical Therapist · Riverview, MI

NPI 1063534071 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1063534071
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
5501004868 (MI)
Practice address
17575 Devonshire St
Riverview, MI 48193-7612
Phone
(734) 624-0111
Fax
(734) 556-1530
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5501004868MIMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501004868 MI Yes

Addresses

Primary practice location

17575 Devonshire St
Riverview, MI 48193-7612

Mailing address

17575 Devonshire St
Riverview, MI 48193-7612
Phone (734) 624-0111

Other names

  • Vincy Davis Professional name

Other providers in Riverview, MI

All providers in Riverview, MI · Physical Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.