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Individual

MARK DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3020 BAILEY AVE, BUFFALO, NY 14215-2814
(716) 831-2700
Mailing address
3020 BAILEY AVE, BUFFALO, NY 14215-2814
(716) 831-2700

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
9767667
NY

Other

Enumeration date
07/05/2017
Last updated
07/21/2022
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