Provider Demographics
NPI:1952718306
Name:DAVIS, ERMA LOUISE (CPTA)
Entity Type:Individual
Prefix:MS
First Name:ERMA
Middle Name:LOUISE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10115 WORNALL RD APT 312
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-4488
Mailing Address - Country:US
Mailing Address - Phone:816-820-6353
Mailing Address - Fax:
Practice Address - Street 1:402 W 1ST ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MO
Practice Address - Zip Code:64720-9277
Practice Address - Country:US
Practice Address - Phone:816-297-2107
Practice Address - Fax:816-297-4321
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO117524225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant