Individual
KEITH ROBERT DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
140 SYLVESTER RD, USS TOPEKA (SSN 754) FPO AP 96679-2410, SAN DIEGO, CA 92106-3521
(619) 553-0123
(619) 553-0744
Mailing address
140 SYLVESTER RD, USS TOPEKA (SSN 754) FPO AP 96679-2410, SAN DIEGO, CA 92106-3521
(619) 553-0123
(619) 553-0744
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
07/13/2007
Last updated
07/13/2007
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