Individual
KIMBERLEY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
376 E APPLE AVE, MUSKEGON, MI 49442-3466
(231) 683-9672
Mailing address
376 E APPLE AVE, MUSKEGON, MI 49442-3466
(231) 683-9672
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003914946
—
MI
Enumeration date
06/09/2020
Last updated
06/09/2020
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