Individual
DR. LAWRENCE ROBERT DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
108 E GIRARD AVE, PHILA, PA 19125
(215) 739-8775
(215) 739-8775
Mailing address
108 E GIRARD AVE, PHILA, PA 19125
(215) 739-8775
(215) 739-8775
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OE005224T
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000839887001
—
PA
Enumeration date
06/20/2006
Last updated
05/14/2008
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