Provider Demographics
NPI:1619118270
Name:DAVIS, ALEXIS (BS, ATC)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:BS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 WAHOO WAY
Mailing Address - Street 2:APT. 212
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-4154
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:290 MASSIE ROAD
Practice Address - Street 2:MCCUE CENTER ROOM 112
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22904
Practice Address - Country:US
Practice Address - Phone:607-437-5789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer