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Tully Booth Davis
Student in an Organized Health Care Education/Training Program in Prattville, Alabama
NPI 1629676747

Tully Booth Davis is a Student in an Organized Health Care Education/Training Program based in Prattville, AL. Tully Booth Davis practices in Prattville, AL. The NPI Number for Tully Booth Davis is 1629676747 and holds a License No. (Alabama).

The current practice location address for Tully Booth Davis is 705 Emerald Dr, Prattville, AL and can be reached out via phone at 205-249-8551.

Location: 705 Emerald Dr, Prattville, AL, 36067-3711
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629676747
Provider Name
Tully Booth Davis
Credential
Provider Entity Type
Individual
Gender
Male
Address
705 Emerald Dr, Prattville, AL, 36067-3711
Phone Number
205-249-8551
Fax Number
Provider Enumeration Date
10/12/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
EIB901379535 01 BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
705 Emerald Dr
City
Prattville
State
Alabama
Zip
36067-3711
Phone Number
205-249-8551
Fax Number
person
Provider Business Mailing Address Details
Address
705 Emerald Dr
City
Prattville
State
Alabama
Zip
36067-3711
Phone Number
205-249-8551
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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