Individual
LORI DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
395 GALE BLVD APT 304, MELVINDALE, MI 48122-1720
(734) 286-1014
Mailing address
395 GALE BLVD APT 304, MELVINDALE, MI 48122-1720
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
06/19/2017
Last updated
06/19/2017
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