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Individual

JOHANNA DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
29028 HUDSON RD, DAGSBORO, DE 19939-3837
(443) 496-6011
Mailing address
29028 HUDSON RD, DAGSBORO, DE 19939-3837
(443) 496-6011

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
140460
MD

Other

Enumeration date
01/14/2015
Last updated
01/14/2015
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