Individual
MR. GENE MARTELL DAVIS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1033 E 78TH ST, CLEVELAND, OH 44103-2065
(216) 376-8688
Mailing address
1033 E 78TH ST, CLEVELAND, OH 44103-2065
(216) 376-8688
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 142635
OH
Other
Enumeration date
01/29/2011
Last updated
01/30/2011
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