Provider Demographics
NPI:1417287160
Name:DAVIS, CHARLES F
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:F
Last Name:DAVIS
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:CHARLES
Other - Middle Name:F
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:232 OLEANDER AVE
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-3807
Mailing Address - Country:US
Mailing Address - Phone:561-236-3303
Mailing Address - Fax:561-833-3817
Practice Address - Street 1:232 OLEANDER AVE
Practice Address - Street 2:
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-3807
Practice Address - Country:US
Practice Address - Phone:561-236-3303
Practice Address - Fax:561-833-3817
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-31
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 24922225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist