Connor Lee Davis
Individual provider Active NPI Chiropractor · Boaz, AL
NPI 1356090591 · NPPES record last updated Aug 12, 2025
Key facts
- NPI
- 1356090591
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2722 (AL)
- Practice address
- 314 Billy Dyar Blvd Ste D
Boaz, AL 35957-2218 - Phone
- (256) 907-9561
- Fax
- (256) 907-9435
- NPI assigned
- Mar 23, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220502000602 | AL | Practitioner - Chiropractic | 7214324763 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2722 | AL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Davis Spine and Sport Recovery LLC | Chiropractor | Current |
Accepting new patients |
Locations
314 Billy Dyar Blvd
Ste D
Boaz, AL 35957
Phone (256) 907-9561
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2722 | AL | Yes |
Addresses
Primary practice location
314 Billy Dyar Blvd Ste D
Boaz, AL 35957-2218
Mailing address
110 N Main St
Boaz, AL 35957-1626
Phone (256) 593-6363
Other providers in Boaz, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.