Organization
DAVIDSON PROSTHETICS LLC
Active
Organization
DAVIDSON PROSTHETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG E DAVIDSON CPO (OWNER)
(253) 651-8250
Entity
Organization
Contact information
Practice address
11919 CANYON RD E, PUYALLUP, WA 98373-4456
(253) 770-6578
(253) 881-1397
Mailing address
11919 CANYON RD E, PUYALLUP, WA 98373-4456
(253) 770-6578
(253) 881-1397
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CPO01874
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9062993
—
WA
Enumeration date
10/03/2008
Last updated
07/21/2022
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