Individual
AGNES SERAFINA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2101 N WATERMAN AVE, SAN BERNARDINO, CA 92404-4836
(909) 883-8711
Mailing address
2101 N WATERMAN AVE, SAN BERNARDINO, CA 92404-4836
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/03/2023
Last updated
05/04/2023
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