Individual
SANDRA P DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
953 NE 9TH ST, GRANTS PASS, OR 97526-1606
(541) 472-8088
Mailing address
953 NE 9TH ST, GRANTS PASS, OR 97526-1606
(541) 472-8088
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6745
OR
Other
Enumeration date
04/23/2008
Last updated
04/23/2008
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