Individual
KEVIN DWAYNE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
571 BLUE LEDGE CIR, LEXINGTON, SC 29072-8349
(267) 454-3501
Mailing address
571 BLUE LEDGE CIR, LEXINGTON, SC 29072-8349
(267) 454-3501
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
260695
SC
Other
Enumeration date
03/07/2023
Last updated
03/07/2023
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