Miguel Davis

NPI #1013790070 in Lake Bluff, Illinois

Provider Information

NPI Number: 1013790070
Entity Type: Individual
Name: Miguel Davis
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Aug 15, 2023
Last Updated: Aug 15, 2023

Practice Location

Address: 101 WAUKEGAN RD STE 1100
City: Lake Bluff
State: Illinois
ZIP Code: 60044-3013
Phone: (847) 247-2402

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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