Individual
JANICE LATRESE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1957 REVERE RD, CLEVELAND, OH 44118-2233
(216) 551-0635
Mailing address
1957 REVERE RD, CLEVELAND HTS, OH 44118-2233
(216) 551-0635
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 126494 M-IV
OH
Other
Enumeration date
06/17/2011
Last updated
06/17/2011
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