Individual
MR. BRANDON HEATH DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
602 DAVID ST, CORNING, AR 72422-7268
(870) 857-3655
(870) 357-3667
Mailing address
602 DAVID ST, CORNING, AR 72422-7268
(870) 857-3655
(870) 857-3667
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L50333
AR
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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