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Individual

L BRENT DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
801 N. MAIN STR., FAITH FAMILY PRACTICE, WEST LIBERTY, KY 41472-1021
(606) 743-1422
(606) 743-1455
Mailing address
801 MAIN ST, WEST LIBERTY, KY 41472-1021
(606) 743-1422

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA120
KY

Other

Enumeration date
01/01/2007
Last updated
09/08/2010
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