Individual
TERESA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9207 US HIGHWAY 68 E, BENTON, KY 42025-6565
(270) 354-5263
Mailing address
267 SLICKBACK RD, BENTON, KY 42025-7629
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1058534
KY
Other
Enumeration date
06/12/2017
Last updated
03/17/2018
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