Individual
MICHAEL A DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
115 GRAND BLVD, BEDFORD, OH 44146-2117
(216) 501-3036
Mailing address
115 GRAND BLVD, BEDFORD, OH 44146-2117
(216) 501-3036
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
RS007745
OH
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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