Russell Eric Davis, P.T.
Individual provider Active NPI Physical Therapist · Apo Ae, NY
NPI 1962562793 · NPPES record last updated Sep 28, 2023
Key facts
- NPI
- 1962562793
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT003021 (GA)
- Practice address
- Physical Therapy Clinic, Grafenweohr, Bmeddac
BLDG 476, Room 107
Apo Ae, NY 09114 - Phone
- (253) 968-0780
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT003021 | GA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT003021 | GA | Yes |
Addresses
Primary practice location
Physical Therapy Clinic, Grafenweohr, Bmeddac
BLDG 476, Room 107
Apo Ae, NY 09114
Mailing address
2005 Eskridge Blvd SE
Olympia, WA 98501-3704
Phone (253) 381-7602
Other names
- Mr. R. Eric Davis
Other providers in Apo Ae, NY
- Malcolm Boykin
- Paul Wendell Brown
- Glenn Robert Casey
- Tracy Louise Coleman
- Benjamin Thompson Cook
- Patricia Anne Deland
- Andrew Draper
- Klaus Eastman
- Kathryn Elizabeth Fournie
- Jason P. Ganong
All providers in Apo Ae, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.