Individual
CASEY LEIGH DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
085.003693
IL
363A00000X
Physician Assistant
085.003693
IL
363A00000X
Physician Assistant
2011030386
MO
363AS0400X
Surgical Physician Assistant
Primary
2011030386
MO
Other
Enumeration date
03/26/2010
Last updated
01/31/2014
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