Individual
CLANCY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
124 SOUTH BROADWAY, SUITE 200, ADA, OK 74820-0000
(580) 332-3001
(580) 332-8774
Mailing address
124 SOUTH BROADWAY, SUITE 200, ADA, OK 74820-0000
(580) 332-3001
(580) 332-8774
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/30/2015
Last updated
09/30/2015
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