Individual
ANGELIQUE MICHELLE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4705 WILLOW BROOK AVE, APT 6, LOS ANGELES, CA 90029
(215) 309-9866
Mailing address
4705 WILLOW BROOK AVE APT 6, LOS ANGELES, CA 90029-1093
(347) 613-2825
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
CA
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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