| Davis Dynamics | |
|
317 Office Square Ln Ste 202b Virginia Beach VA 23462-3663 | |
| (757) 918-9874 | |
| Not Available |
| Full Name | Davis Dynamics |
|---|---|
| Speciality | Clinic/Center |
| Location | 317 Office Square Ln Ste 202b, Virginia Beach, Virginia |
| Authorized Official Name and Position | Jana K Davis (CEO) |
| Authorized Official Contact | 6183159464 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Davis Dynamics 8009 Elaine Ct Norfolk VA 23518-3004 Ph: (618) 315-9464 | Davis Dynamics 317 Office Square Ln Ste 202b Virginia Beach VA 23462-3663 Ph: (757) 918-9874 |
| NPI Number | 1013499565 |
|---|---|
| Provider Enumeration Date | 08/31/2018 |
| Last Update Date | 08/14/2019 |
| Medicare PECOS PAC ID | 2961748298 |
|---|---|
| Medicare Enrollment ID | O20190108002032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013499565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (NU) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | (NU) | Primary |
| Provider Name | Jana K Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689703985 PECOS PAC ID: 1557508959 Enrollment ID: I20160801000350 |
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