Organization
LAWRENCE R. DAVIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE R. DAVIS (OWNER)
(215) 739-8775
Entity
Organization
Contact information
Practice address
108 E GIRARD AVE, PHILA, PA 19125-3908
(215) 739-8775
(215) 739-8775
Mailing address
108 E GIRARD AVE, PHILA, PA 19125-3908
(215) 739-8775
(215) 739-8775
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
OE005224T
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000839887OOO1
—
PA
Enumeration date
06/04/2008
Last updated
06/04/2008
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