Individual
CHARLES R. DAVIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
HHA
Contact information
Practice address
436 E CARPENTER DR, NEW CARLISLE, OH 45344-2529
(937) 238-1347
Mailing address
436 E CARPENTER DR, NEW CARLISLE, OH 45344-2529
(937) 238-1347
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107010732999
—
OH
Enumeration date
08/07/2014
Last updated
08/07/2014
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