Individual
JUSTIN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LGP
Contact information
Practice address
12502 WILLOWBROOK RD STE 380, CUMBERLAND, MD 21502-6592
(240) 964-8585
(240) 964-8586
Mailing address
12502 WILLOWBROOK RD STE 380, CUMBERLAND, MD 21502-6592
(240) 964-8585
(240) 964-8586
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LGP6648
MD
Other
Enumeration date
06/07/2017
Last updated
07/21/2022
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