Individual
KENNETH A. DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 SAND ISLAND PKWY, CGC KUKUI (WLB-203), HONOLULU, HI 96819-4326
(808) 842-2860
(808) 842-2864
Mailing address
4200 OCEAN ST, USCG SECTOR JACKSONVILLE, ATLANTIC BEACH, FL 32233
(904) 564-7581
(904) 564-7583
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
02/06/2007
Last updated
11/02/2012
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