Individual
TOM DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 MAINE ST, EADS, CO 81036-9900
(719) 438-5832
(719) 438-5592
Mailing address
PO BOX 10, EADS, CO 81036-0010
(719) 438-5832
(719) 438-5593
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0330000001
CO
Other
Enumeration date
02/01/2019
Last updated
02/01/2019
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