Individual
MORIOLE C DAVIS I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(386) 423-0477
Mailing address
137 SW FULTON PL, LAKE CITY, FL 32024-3779
(386) 439-0477
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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