Mckenna Larae Davidson
Specialist/Technologist, Athletic Trainer in Des Moines, IA. Individual provider (NPI-1).
NPI number1871258830
StatusActive
Last updated in NPPESNov 4, 2021
Details
- NPI
- 1871258830
- Entity type
- Individual (NPI-1)
- Name
- Mckenna Larae Davidson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 4, 2021
- Certification date
- Nov 4, 2021
- Last updated
- Nov 4, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | IA | Yes |
Practice location
1200 Grandview AveDes Moines, IA 50316-1529
Phone 515-263-2800
Mailing address
1650 Lakeview DrPleasant Hill, IA 50327-2326
Phone 515-402-6750
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