Individual
CORY BENNETT DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3822 COLONIAL AVE STE C, ERIE, PA 16506-3826
(814) 616-0321
(814) 528-5643
Mailing address
3822 COLONIAL AVE STE C, ERIE, PA 16506-3826
(814) 616-0321
(814) 528-5643
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA053612
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA053612
LICENSE
PA
Enumeration date
09/24/2008
Last updated
02/02/2024
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