Individual
MRS. VANITY SHANEKA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDMT
Contact information
Practice address
101 BODIN CIR, SGPF, TRAVIS AFB, CA 94535-1809
(707) 423-3247
Mailing address
2003 TOLENAS AVE, FAIRFIELD, CA 94533-2742
(707) 423-3247
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
05/04/2009
Last updated
05/04/2009
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