Individual
JODI DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
809 N 19TH STREET, MIDDLESBORO, KY 40965
(606) 248-3042
(606) 248-3060
Mailing address
PO BOX 271, MIDDLESBORO, KY 40965-0271
(865) 585-5404
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1208505
KY
Other
Enumeration date
05/28/2024
Last updated
05/28/2024
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