Individual
MR. LARRY V DAVISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R. PH.
Contact information
Practice address
1600 N 2ND ST, CLINTON, MO 64735-1192
(660) 885-5511
Mailing address
800 W JEFFERSON ST, CLINTON, MO 64735-1939
(660) 885-5511
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
09115
KS
183500000X
Pharmacist
Primary
28369
MO
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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