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Individual

DR. RICHARD SCOTT DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
170 S MAIN ST, FREDERICKTOWN, OH 43019-9087
(740) 694-0553
(740) 694-0653
Mailing address
29 ADENA CT, FREDERICKTOWN, OH 43019-9027
(740) 694-0753

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2892
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2302038
OH
01
31-17-108-15
FEDERAL TAX ID
OH
Enumeration date
03/07/2007
Last updated
07/09/2007
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