Individual
DONNA DAVIS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
1507 BRAVO BLVD, GLASGOW, KY 42141-3478
(270) 651-2181
(270) 651-2183
Mailing address
1507 BRAVO BLVD, GLASGOW, KY 42141-3478
(270) 651-2181
(270) 651-2183
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
451
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
451
OPTICIAN LICENSE
KY
Enumeration date
10/26/2005
Last updated
07/08/2007
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