Provider Demographics
NPI:1679900831
Name:DAVIS, CINDY RENA (PT)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:RENA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1671 CONGER RD
Mailing Address - Street 2:
Mailing Address - City:UNION POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30669-1654
Mailing Address - Country:US
Mailing Address - Phone:706-817-0925
Mailing Address - Fax:706-453-5014
Practice Address - Street 1:1201 SILOAM RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:GA
Practice Address - Zip Code:30642-2811
Practice Address - Country:US
Practice Address - Phone:706-453-5088
Practice Address - Fax:706-453-5014
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008067225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist