Individual
DOUGLAS DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1662 MARS AVE, LAKEWOOD, OH 44107-3825
(216) 282-3838
Mailing address
1662 MARS AVE, LAKEWOOD, OH 44107-3825
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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