Provider Demographics
NPI:1063274454
Name:DAVIS, BRITTANY LAVONNA (DC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LAVONNA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17301 W 8 MILE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-2141
Mailing Address - Country:US
Mailing Address - Phone:313-533-2225
Mailing Address - Fax:313-533-8025
Practice Address - Street 1:17301 W 8 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-2141
Practice Address - Country:US
Practice Address - Phone:313-533-2225
Practice Address - Fax:313-533-8025
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301401489111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor