Individual
HEATHER A DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9471 MARKET ST STE A, NORTH LIMA, OH 44452-8702
(330) 726-7100
(330) 758-0347
Mailing address
9471 MARKET ST STE A, NORTH LIMA, OH 44452-8702
(330) 726-7100
(330) 758-0347
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.003849RX
OH
363AM0700X
Medical Physician Assistant
50003849
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0095095
—
OH
Enumeration date
12/03/2013
Last updated
07/12/2019
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