Individual
BREANNA JO DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5115 HAMPTON BOULEVARD, NORFOLK, VA 23529-0001
(757) 683-4960
Mailing address
336 CANN RD, ANDERSON, SC 29625-6505
(864) 940-6533
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/20/2020
Last updated
05/20/2020
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