Individual
MR. MARK ANTHONY DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
448 E 272ND ST, EUCLID, OH 44132-1730
(216) 780-3204
Mailing address
448 E 272ND ST, EUCLID, OH 44132-1730
(216) 780-3204
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
RP928998
OH
Other
Enumeration date
04/10/2009
Last updated
04/10/2009
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