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Individual

CODY MICHAEL DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
613 W MAIN ST, LOUISVILLE, OH 44641-1335
(330) 875-1429
(330) 875-2753
Mailing address
646 CATHY ANN DR, BOARDMAN, OH 44512-6552
(330) 770-7943

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03440953
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03440953
OHIO STATE BOARD OF PHARMACY
OH
Enumeration date
08/04/2021
Last updated
08/04/2021
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