# JAKE COBURN DAVIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1841824521
- **Gender:** Man
- **Credential:** CPO, MSPO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 222Z00000X | Orthotist | CO005925 | NULL | — |
| 224P00000X | Prosthetist | CPO04745 | NULL | Yes |

## Other

- **Enumeration date:** 03/03/2020
- **Last updated:** 11/14/2022