Individual
JOHN ROBERT DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4400 NORTH MAIN STREET, ROSWELL, NM 88201
(505) 627-9872
Mailing address
104 FAIRWAY DR, DEXTER, NM 88230-9635
(505) 734-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
228
NM
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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