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Individual

CARSON LEE DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1307 LAKE AVE, GOTHENBURG, NE 69138-1744
(308) 325-5518
Mailing address
1307 LAKE AVE, GOTHENBURG, NE 69138-1744
(308) 325-5518

Taxonomy

Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary
G18018081
NE

Other

Enumeration date
01/04/2022
Last updated
01/04/2022
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