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Individual

MRS. CLARA M DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1719 W DUBAIL ST, SOUTH BEND, IN 46613-1216
(574) 233-2287
Mailing address
1719 W DUBAIL ST, SOUTH BEND, IN 46613-1216
(574) 233-2287

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary

Other

Enumeration date
05/29/2012
Last updated
05/29/2012
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