Individual
DR. KELLY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
500 LINCOLN DR, SUITE A, HERRIN, IL 62948-6334
(618) 351-8900
(618) 351-0076
Mailing address
2800 W MAIN ST, CARBONDALE, IL 62901-1087
(618) 351-8900
(618) 351-0076
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
IL
Other
Enumeration date
01/03/2007
Last updated
07/08/2007
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