Provider Demographics
NPI:1740497841
Name:DAVIS, RALPH D (DC)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:D
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 HIGH POINT NORTH DR
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-5907
Mailing Address - Country:US
Mailing Address - Phone:404-358-5787
Mailing Address - Fax:
Practice Address - Street 1:29 MILLARD FARMER IND BLVD
Practice Address - Street 2:SUITE A1
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-5821
Practice Address - Country:US
Practice Address - Phone:404-358-5787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007955111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor