Individual
DANIELLE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 S COMMERCIAL ST, HARRISBURG, IL 62946-1719
(618) 841-7995
Mailing address
1 S COMMERCIAL ST, HARRISBURG, IL 62946-1719
(618) 253-8182
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051302686
IL
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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