Individual
CLAY DENEEEN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4509 W STONE DR, KINGSPORT, TN 37660-1048
(423) 578-6484
Mailing address
4509 W STONE DR, KINGSPORT, TN 37660-1048
(423) 578-6484
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1333
TN
Other
Enumeration date
07/03/2007
Last updated
04/14/2014
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