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Individual

JEREMY DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MHPP

Contact information

Practice address
11321 INTERSTATE 30, SUITE 104, LITTLE ROCK, AR 72209-7040
(501) 315-3344
Mailing address
11321 INTERSTATE 30, SUITE 104, LITTLE ROCK, AR 72209-7040
(501) 315-3344

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
12/05/2007
Last updated
01/13/2011
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