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Davin Ray Modisette
Radiologic Technologist in Jackson, Tennessee
NPI 1356721245

Davin Ray Modisette is a Radiologic Technologist based in Jackson, TN. Davin Ray Modisette practices in Jackson, TN. The NPI Number for Davin Ray Modisette is 1356721245 and holds a License No. 487010 (Tennessee).

The current practice location address for Davin Ray Modisette is 23 Westhaven Pl, Jackson, TN and can be reached out via phone at 318-475-0690 and via fax at 731-435-3385.

Location: 23 Westhaven Pl, Jackson, TN, 38305-1758
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1356721245
Provider Name
Davin Ray Modisette
Credential
Provider Entity Type
Individual
Gender
Male
Address
23 Westhaven Pl, Jackson, TN, 38305-1758
Phone Number
318-475-0690
Fax Number
731-435-3385
Provider Enumeration Date
06/04/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
23 Westhaven Pl
City
Jackson
State
Tennessee
Zip
38305-1758
Phone Number
318-475-0690
Fax Number
731-435-3385
person
Provider Business Mailing Address Details
Address
23 Westhaven Pl
City
Jackson
State
Tennessee
Zip
38305-1758
Phone Number
318-475-0690
Fax Number
731-435-3385
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Radiologic Technologist
Speciality
-
Taxonomy
247100000X
License No.
487010 (Tennessee)
Definition
An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment.
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