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Individual
TERRY LEE DAVIS
Active
Individual
TERRY LEE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13892
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13892
STATE LICENSE
KY
Enumeration date
08/27/2006
Last updated
07/08/2007
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