Individual
ANTHONY RAY DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
526 W 6TH ST, ADA, OK 74820-3220
(405) 374-1225
Mailing address
526 W 6TH ST, ADA, OK 74820-3220
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/10/2021
Last updated
01/10/2021
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