Individual
MARTHA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2553 HARTEL ST, FORT MEADE, MD 20755
(863) 968-4852
Mailing address
8306 HOLLAND PL, LAWRENCEVILLE, GA 30043-8650
(863) 968-4852
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
81-1643976
FL
247ZC0005X
Clinical Laboratory Director (Non-physician)
—
GA
3747P1801X
Personal Care Attendant
Primary
BL-002344-2020
GA
Other
Enumeration date
09/01/2016
Last updated
12/31/2021
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