Individual
MS. LESA ELAINE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
600 BLUES LAKE PKWY, ROLLA, MO 65401-8022
(573) 364-8823
(573) 341-5969
Mailing address
600 BLUES LAKE PKWY, ROLLA, MO 65401-8022
(573) 364-8823
(573) 341-5969
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2006005292
MO
Other
Enumeration date
06/01/2006
Last updated
06/23/2010
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