Provider Demographics
NPI:1356336606
Name:DAVIS, JAMES ROSS (ATC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ROSS
Last Name:DAVIS
Suffix:
Gender:M
Credentials:ATC
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Mailing Address - Street 1:2709 LEGISLATIVE LN
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-8037
Mailing Address - Country:US
Mailing Address - Phone:770-540-7441
Mailing Address - Fax:770-539-9217
Practice Address - Street 1:655 JESSE JEWELL PKWY SE
Practice Address - Street 2:GAINESVILLE
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3722
Practice Address - Country:US
Practice Address - Phone:770-539-9001
Practice Address - Fax:770-539-9217
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GA0003152255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000315OtherSTATE LICENSE NUMBER