Individual
CHAUNCEY DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4400 SOUTH JONES BLVD, STE. 1055, LAS VEGAS, NV 89103
(704) 449-8511
Mailing address
PO BOX 379, TOLLESON, AZ 85353
(704) 449-8511
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/24/2010
Last updated
09/24/2010
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