Individual
DR. DARRELL WADE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1155 YELLOWSTONE AVE, STE. F, POCATELLO, ID 83201-4369
(208) 238-0002
Mailing address
1155 S. YELLOWSTONE, STE. F, POCATELLO, ID 83201
(208) 238-0002
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA716
ID
Other
Enumeration date
02/21/2007
Last updated
04/27/2010
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