National Provider Identifier
Jackie Lyn Davis, PT
Jackie Lyn Davis, PT is listed in the NPPES registry with a primary specialty of Physical Therapist in Olean, NY and a listed phone number of (716) 372-2808.
Profile Overview
- NPI
- 1063586964
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- November 20, 2006
- Last Updated
- July 08, 2007
Practice Location
- 2416 Constitution Avenue
- Rehabilitation Today
- Olean, NY 14760
Phone: (716) 372-2808
Specialties
- Physical Therapist (225100000X)
- Physical Therapist (225100000X)
Full Record
- NPI
- 1063586964
- Entity Type
- Individual
- Last Name
- Davis
- First Name
- Jackie
- Middle Name
- Lyn
- Credential
- PT
- Provider Other Last Name
- Yunker
- Provider Other First Name
- Jackie
- Provider Other Middle Name
- Lyn
- Provider Other Last Name Type Code
- 5
- Mailing Street Address
- 2416 Constitution Avenue
- Mailing Address Line 2
- Rehabilitation Today
- Mailing City
- Olean
- Mailing State
- NY
- Mailing ZIP Code
- 14760
- Mailing Country
- US
- Mailing Phone
- (716) 372-2808
- Mailing Fax
- (716) 372-2902
- Practice Street Address
- 2416 Constitution Avenue
- Practice Address Line 2
- Rehabilitation Today
- Practice City
- Olean
- Practice State
- NY
- Practice ZIP Code
- 14760
- Practice Country
- US
- Practice Phone
- (716) 372-2808
- Practice Fax
- (716) 372-2902
- Enumeration Date
- November 20, 2006
- Last Updated
- July 08, 2007
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X), Physical Therapist (225100000X)
- Other Identifiers
- 000626459001 (NY, BCBS Wny), 6697122 (NY, Ghi), 00011264701 (NY, Univeca)