Individual
ILA C DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11720 COMMON RD, WARREN, MI 48093-5628
(810) 388-1200
Mailing address
34625 MULVEY, APT 242, FRASER, MI 48026-1924
(810) 388-1200
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
12/15/2006
Last updated
07/08/2007
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