Individual
DR. GREG C. DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2240 MCCULLOCH BLVD N, STE C, LAKE HAVASU CITY, AZ 86403-6904
(928) 453-2225
(928) 453-4791
Mailing address
2240 MCCULLOCH BLVD N, STE C, LAKE HAVASU CITY, AZ 86403-6904
(928) 453-2225
(928) 453-4791
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
4259
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0243840
BLUE CROSS PROVIDER
AZ
Enumeration date
08/28/2006
Last updated
09/12/2017
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