Individual
COREY JAMES DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 NW 63RD ST, SUITE 600, OKLAHOMA CITY, OK 73116-7907
(405) 848-2171
Mailing address
267 LIVING SPRINGS TRL, GOLDSBY, OK 73093-9003
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/17/2011
Last updated
11/17/2011
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