Joann Davis, PTA

Individual provider Active NPI Case Manager/Care Coordinator · Easley, SC

NPI 1962729376 · NPPES record last updated Apr 24, 2010

Key facts

NPI
1962729376
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
License
2196 (SC)
Practice address
255 Gibson Rd
Easley, SC 29640-7803
Phone
(864) 306-3383
NPI assigned
Apr 24, 2010
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)
No

State licenses

LicenseStateTypeSpecialty
2196SCMDCase Manager/Care Coordinator

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 2196 SC Yes

Addresses

Primary practice location

255 Gibson Rd
Easley, SC 29640-7803

Mailing address

255 Gibson Rd.
Easley, SC 29640-7803
Phone (864) 306-3383

Other providers in Easley, SC

All providers in Easley, SC · Case Manager/Care Coordinator in South Carolina

Sources for this page

Verify at the official NPI Registry.