Provider Demographics
NPI:1205142064
Name:DAVIS, KATHRYN ELIZABETH (DC)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ELIZABETH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-1945
Mailing Address - Country:US
Mailing Address - Phone:770-253-5040
Mailing Address - Fax:770-253-5040
Practice Address - Street 1:35 JACKSON ST
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-1945
Practice Address - Country:US
Practice Address - Phone:770-253-5040
Practice Address - Fax:770-253-5040
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008709111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor