Provider Demographics
NPI:1609752047
Name:DAVIS SPINE AND SPORT RECOVERY
Entity type:Organization
Organization Name:DAVIS SPINE AND SPORT RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CONNOR
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-907-9561
Mailing Address - Street 1:314 BILLY DYAR BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:BOAZ
Mailing Address - State:AL
Mailing Address - Zip Code:35957-2218
Mailing Address - Country:US
Mailing Address - Phone:256-907-9561
Mailing Address - Fax:256-907-9435
Practice Address - Street 1:314 BILLY DYAR BLVD STE D
Practice Address - Street 2:
Practice Address - City:BOAZ
Practice Address - State:AL
Practice Address - Zip Code:35957-2218
Practice Address - Country:US
Practice Address - Phone:256-907-9561
Practice Address - Fax:256-907-9435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty