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Individual

DHYLLES DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
104 E 40TH ST STE B, SAVANNAH, GA 31401-9119
(347) 863-8813
Mailing address
1 COASTAL PL APT 7, SAVANNAH, GA 31406-5535
(347) 863-8813

Taxonomy

Speciality
Code
Description
License number
State
374K00000X
Religious Nonmedical Practitioner
Primary
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
83-4632387
OUT OF POCKET PAYMENTS
GA
Enumeration date
12/03/2019
Last updated
12/03/2019
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