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DR. KELLY NICOLE DAVIS DPT, ATC, COMT, CSCS

Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1902235146

Individual Registrant:
DR. KELLY NICOLE DAVIS DPT, ATC, COMT, CSCS
Gender: F
Not Sole Proprietor

Location and contact information for practice:
35325 DATE PALM DR STE 131  CATHEDRAL CITY, CA 92234-7031 US
Tel: 760-202-0368  Fax: 760-770-1973

Contact information for business:
1106 WALNUT ST STE 110  SAN LUIS OBISPO, CA 93401-2416 US
Tel: 805-788-0805  Fax: 805-788-0845

Registration Information:
NPI: 1902235146
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
Athletic Trainer
FLAL 3707
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
CA299323
N225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
FLPT 28657

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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