Provider Demographics
NPI:1467083782
Name:DAVIS, KAITLIN CHRISTINE (PHYSICAL THERAPIST)
Entity Type:Individual
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First Name:KAITLIN
Middle Name:CHRISTINE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:12100 BLACK SWAN DRIVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958
Mailing Address - Country:US
Mailing Address - Phone:302-644-5591
Mailing Address - Fax:302-449-2047
Practice Address - Street 1:12100 BLACK SWAN DRIVE
Practice Address - Street 2:SUITE 202
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958
Practice Address - Country:US
Practice Address - Phone:302-644-5591
Practice Address - Fax:302-449-2047
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist