Individual
MRS. ELIZABETH DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
804 N TRENTON ST, RUSTON, LA 71270-3326
(318) 254-0033
(318) 254-0034
Mailing address
PO BOX 698, RUSTON, LA 71273-0698
(318) 254-0033
(318) 254-0034
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
—
—
Other
Enumeration date
01/11/2017
Last updated
01/11/2017
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