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Individual

JESSICA MICHELLE DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
5535 S SCATTERFIELD RD, ANDERSON, IN 46013-3140
(765) 642-7822
Mailing address
10660 S COUNTY ROAD 800 W, DALEVILLE, IN 47334-9713
(765) 748-5219

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003724A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201077970
IN
Enumeration date
06/05/2012
Last updated
06/21/2013
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