Provider Demographics
NPI:1114699964
Name:RAPP, DAVIS LOY (PTA)
Entity Type:Individual
Prefix:
First Name:DAVIS
Middle Name:LOY
Last Name:RAPP
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 WATERSTONE PARK CIR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-9882
Mailing Address - Country:US
Mailing Address - Phone:828-850-1906
Mailing Address - Fax:
Practice Address - Street 1:5660 DURHAM RD
Practice Address - Street 2:
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27574-7958
Practice Address - Country:US
Practice Address - Phone:336-598-4697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA7285225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant