Individual
NICHOLAS J DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1008 RIVERBURCH PKWY, DALTON, GA 30721-8630
(706) 278-0518
(706) 275-9715
Mailing address
1008 RIVERBURCH PKWY, DALTON, GA 30721-8630
(706) 278-0518
(706) 275-9715
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002251
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
384536109A
—
GA
01
—
OPT002251
STATE LICENSE NUMBER
GA
Enumeration date
07/07/2006
Last updated
03/29/2011
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