Individual
JILL MARIE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
500 LIMIT ST, LEAVENWORTH, KS 66048-4435
(913) 682-5118
(913) 682-4664
Mailing address
500 LIMIT ST, LEAVENWORTH, KS 66048-4435
(913) 682-5118
(913) 682-4664
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01786
KS
Other
Enumeration date
03/06/2015
Last updated
03/06/2015
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