Provider Demographics
NPI:1609342377
Name:DAVIS, JANET MARIE
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:MARIE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 HEMLOCK BEACH DR
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MI
Mailing Address - Zip Code:49274-8628
Mailing Address - Country:US
Mailing Address - Phone:517-398-3832
Mailing Address - Fax:
Practice Address - Street 1:300 E CHICAGO ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-1688
Practice Address - Country:US
Practice Address - Phone:517-279-5420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist