Individual
MARK DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1916 MILLGATE RD, ANDERSON, SC 29621-2936
(864) 293-3509
Mailing address
1916 MILLGATE RD, ANDERSON, SC 29621-2936
(864) 293-3509
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
150455E
SC
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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