Individual
KIZZY L DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3615 PERCIVAL RD LOT 75, COLUMBIA, SC 29223-4275
(803) 667-5888
Mailing address
4464 DEVINE ST STE 1241M, COLUMBIA, SC 29205-3605
(803) 667-5888
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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