Individual
WENDELL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
297 FOXHALL RD, SPARTANBURG, SC 29306-5509
(864) 978-2875
Mailing address
297 FOXHALL RD, SPARTANBURG, SC 29306-5509
(864) 978-2875
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
4461814
SC
Other
Enumeration date
10/04/2016
Last updated
10/04/2016
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