Individual
MARC JOEL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
2190 MERCEDES DR, LYNDEN, WA 98264-3914
(360) 318-4531
Mailing address
2190 MERCEDES DR, LYNDEN, WA 98264-3914
(360) 318-4531
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60511472
WA
Other
Enumeration date
10/15/2014
Last updated
10/15/2014
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