Individual
COREY AHMAD DAVIS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8615 ISLA VISTA VALLEY CT, LAS VEGAS, NV 89178-7521
(702) 606-9376
Mailing address
53 BROKEN PUTTER WAY, LAS VEGAS, NV 89148-5242
(609) 204-6611
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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