Individual
ALICIA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3001 WARRIOR LN, POPLAR BLUFF, MO 63901-8685
(573) 686-1200
Mailing address
3001 WARRIOR LN, POPLAR BLUFF, MO 63901-8685
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
05/22/2014
Last updated
05/22/2014
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