Individual
BRUCE TERRIEL DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
416 COVE BEACH AVE, SHEFFIELD LAKE, OH 44054-1819
(216) 403-5413
(440) 332-3820
Mailing address
416 COVE BEACH AVE, SHEFFIELD LAKE, OH 44054-1819
(440) 949-3090
(440) 332-3820
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN102551
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271-66-72
—
OH
Enumeration date
03/10/2007
Last updated
06/14/2010
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