Individual
ABBY LYNN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 NW 12TH ST, FRUITLAND, ID 83619-5040
(208) 452-6556
Mailing address
1100 NW 12TH ST, FRUITLAND, ID 83619-5040
(208) 452-6556
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
PA-2612
ID
Other
Enumeration date
06/10/2022
Last updated
01/09/2024
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