Individual
JACQULYNE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPSGT/RST
Contact information
Practice address
10701 EAST BLVD, CLEVELAND, OH 44106-1702
(216) 791-3800
Mailing address
10701 EAST BLVD, CLEVELAND, OH 44106-1702
(216) 791-3800
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
211114
OH
Other
Enumeration date
01/23/2024
Last updated
01/23/2024
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