Individual
BIRGIT DAVIS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
504 WABASH CIR, HUNTINGTON, IN 46750-8413
(260) 224-5281
Mailing address
504 WABASH CIR, HUNTINGTON, IN 46750-8413
(260) 224-5281
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200911410 A
—
IN
Enumeration date
11/04/2008
Last updated
11/04/2008
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