Dr NICKALUS SHANE DAVIS is a male medical professional, specializing in Physical Therapy. He graduated in 2018.
MRC LLC
450 W STATE ST
SUITE 270
EAGLE
ID
836166974
Tel: 9258567007
| Npi | 1336615749 |
| Pac Id | 3476892357 |
| Professional Enrollment Id | I20190312001256 |
| Last Name | DAVIS |
| First Name | NICKALUS |
| Middle Name | SHANE |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 2018 |
| Primary Specialty | PHYSICAL THERAPY |
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| Organization Legal Name | MRC LLC |
| Group Practice Pac Id | 0648528570 |
| Number Of Group Practice Members | 2 |
| Line 1 Street Address | 450 W STATE ST |
| Line 2 Street Address | SUITE 270 |
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| City | EAGLE |
| State | ID |
| Zip Code | 836166974 |
| Phone Number | 9258567007 |
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| Professional Accepts Medicare Assignment | Y |
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