IndividualActive
Brantley Davis, COTA
NPI 1003191461 · Occupational Therapy Assistant · Sumrall, MS
Provider details
- NPI number
- 1003191461
- Entity type
- Individual
- Primary specialty
- Occupational Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- COTA
- Sex
- Male
- Sole proprietor
- Yes
- License
- 211203 (TX)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
19 N Mill St
Sumrall, MS 39482-4035
Phone: (601) 466-9638
Approximate (ZIP-level) locationGet directions
Mailing address
19 N Mill St
Sumrall, MS 39482-4035
Registry dates
- Enumerated
- 2011-10-18
- Last updated
- 2011-10-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.