Individual
DR. CARL MICHAEL DAVIDSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
15 JERSEY AVE, PORT JERVIS, NY 12771-2436
(845) 856-6681
Mailing address
PO BOX 320, WESTBROOKVILLE, NY 12785-0320
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
060159
NY
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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