Individual
CRYSTINA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
602 EDWARDS ST APT F, PORTSMOUTH, VA 23704-6748
(757) 372-7501
Mailing address
602 EDWARDS ST APT F, PORTSMOUTH, VA 23704-6748
(757) 372-7501
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
T60699412
VA
172A00000X
Driver
—
—
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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