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Organization
HEALTHY SOURCE RX INC
Active
Organization
HEALTHY SOURCE RX INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY DAVIS (OWNER)
(310) 574-2777
Entity
Organization
Contact information
Practice address
2801 WILSHIRE BLVD STE A, SANTA MONICA, CA 90403-4801
(310) 574-2777
Mailing address
1112 MONTANA AVE STE 900, SANTA MONICA, CA 90403-1652
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
06/20/2019
Last updated
06/20/2019
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