Individual
CHARLES LAURIE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1680 CHAMBERS ST, EUGENE, OR 97402-3655
(541) 686-1916
(541) 686-6018
Mailing address
PO BOX 1648, EUGENE, OR 97440-1648
(541) 242-4026
(541) 242-4363
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0833
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
230078
—
OR
Enumeration date
01/25/2006
Last updated
06/20/2008
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