Provider Demographics
NPI:1801230396
Name:DAVIS, EVA AL-KHOURI (PT)
Entity Type:Individual
Prefix:MRS
First Name:EVA
Middle Name:AL-KHOURI
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 1:508 WHEDDON CROSS WAY
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-4008
Mailing Address - Country:US
Mailing Address - Phone:336-287-1815
Mailing Address - Fax:
Practice Address - Street 1:2920 HIGHWOODS BLVD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-0010
Practice Address - Country:US
Practice Address - Phone:919-350-0554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17005225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist