Individual
MICHEAL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6047 TYVOLA GLEN CIR STE 113, CHARLOTTE, NC 28217-6431
(803) 431-5044
Mailing address
6047 TYVOLA GLEN CIR STE 113, CHARLOTTE, NC 28217-6431
(803) 431-5044
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
2019-3729-01
NC
Other
Enumeration date
11/10/2020
Last updated
09/15/2021
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