Individual
LAURA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1966 HILL DR, GRENADA, MS 38901-5047
(662) 226-2442
(662) 226-9567
Mailing address
1966 HILL DR, GRENADA, MS 38901-5047
(662) 226-2442
(662) 226-9567
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1611
MS
Other
Enumeration date
12/15/2009
Last updated
12/15/2009
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