Individual
WILLIE MICHAEL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HEARING AID DISPENSE
Contact information
Practice address
1498 E MAIN ST, SUITE NO. 108, COTTAGE GROVE, OR 97424-2204
(541) 942-8444
Mailing address
1498 E MAIN ST, SUITE NO. 108, COTTAGE GROVE, OR 97424-2204
(541) 942-8444
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HASP10135362
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HASP10135362
OREGON LICENSE NUMBER
OR
Enumeration date
11/10/2010
Last updated
11/10/2010
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