Individual
LINDA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2501 PARK PLACE DR, GRETNA, LA 70056-3025
(678) 268-7044
Mailing address
2501 PARK PLACE DR, GRETNA, LA 70056-3025
(678) 268-7044
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
059200257
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
455282684
FEDERAL TAX
GA
Enumeration date
01/05/2016
Last updated
01/05/2016
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