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Individual

RONDAL L DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
74 BROOKSEDGE DR E, PATASKALA, OH 43062-7339
(614) 496-2726
Mailing address
74 BROOKSEDGE DR E, PATASKALA, OH 43062-7339
(614) 496-2726

Taxonomy

Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2192443
OH
Enumeration date
11/30/2020
Last updated
11/30/2020
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