NPI 1407646805

Noah Mikael Davis, MSLATATC

Practitioner Athletic Trainer Charleston, IL

Practice location

Address: 600 Lincoln Ave, Charleston, IL 61920-3099
Phone: (618) 554-8410
Mailing address: 2020 10th St APT 102, Charleston, IL 61920-3436

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

Other Specialist/Technologist providers in Illinois →

Registry record

NPI: 1407646805
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 May 2025
Record last updated: 8 May 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.