Individual
MS. LAURIE JANE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5215 CLOVELLY DR, LORAIN, OH 44053-1623
(440) 242-8186
Mailing address
5215 CLOVELLY DR, LORAIN, OH 44053-1623
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
4705916
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0396846
—
OH
Enumeration date
11/13/2020
Last updated
11/13/2020
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