Joseph R Davis

Individual provider Active NPI Athletic Trainer · Hanahan, SC

NPI 1578093209 · NPPES record last updated Jun 15, 2017

Key facts

NPI
1578093209
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
6015 Murray Dr
Hanahan, SC 29410-2241
Phone
(843) 820-3710
NPI assigned
Jun 15, 2017
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

6015 Murray Dr
Hanahan, SC 29410-2241

Mailing address

1167 Startrail LN
Johns Island, SC 29455-3263

Other providers in Hanahan, SC

All providers in Hanahan, SC · Athletic Trainer in South Carolina

Sources for this page

Verify at the official NPI Registry.