Provider Demographics
NPI:1881459519
Name:DAVIS, JAMES MARTIN (PTA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MARTIN
Last Name:DAVIS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2170 HENDERSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-5704
Mailing Address - Country:US
Mailing Address - Phone:828-490-4499
Mailing Address - Fax:828-348-5485
Practice Address - Street 1:2170 HENDERSONVILLE RD
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-5704
Practice Address - Country:US
Practice Address - Phone:828-490-4499
Practice Address - Fax:828-348-5485
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA6065225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant