Provider Demographics
NPI:1194330613
Name:DAVIS, JOSEPH (DPT)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14418 W MEEKER BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-5292
Mailing Address - Country:US
Mailing Address - Phone:623-888-3450
Mailing Address - Fax:
Practice Address - Street 1:14418 W MEEKER BLVD STE 301
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5292
Practice Address - Country:US
Practice Address - Phone:623-888-3450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP19808225100000X
AZLPT-31525225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty