Provider Demographics
NPI:1932686235
Name:DAVIS, TAYLA
Entity Type:Individual
Prefix:
First Name:TAYLA
Middle Name:
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 1:3523 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:DOLOMITE
Mailing Address - State:AL
Mailing Address - Zip Code:35061-1134
Mailing Address - Country:US
Mailing Address - Phone:205-276-5277
Mailing Address - Fax:
Practice Address - Street 1:3523 CHURCH ST
Practice Address - Street 2:
Practice Address - City:DOLOMITE
Practice Address - State:AL
Practice Address - Zip Code:35061-1134
Practice Address - Country:US
Practice Address - Phone:205-276-5277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health