Provider Demographics
NPI:1023652203
Name:DAVIDSON, ALAN (DPT)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:DAVIDSON
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 1:5839 CREEK STATION DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8626
Mailing Address - Country:US
Mailing Address - Phone:601-508-4827
Mailing Address - Fax:
Practice Address - Street 1:7030 PINE FOREST RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32526-3920
Practice Address - Country:US
Practice Address - Phone:850-944-5360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist