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Individual

DR. JEFFREY A DAVISSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
33 ELVA CT, VANDALIA, OH 45377-1828
(937) 898-3641
(937) 898-4322
Mailing address
33 ELVA CT, VANDALIA, OH 45377-1828
(937) 898-3641
(937) 898-4322

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4920
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2061503
OH
Enumeration date
06/27/2006
Last updated
01/03/2008
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