Alicia Davis

NPI #1750793931 in Poplar Bluff, Missouri

Provider Information

NPI Number: 1750793931
Entity Type: Individual
Name: Alicia Davis
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: May 22, 2014
Last Updated: May 22, 2014

Practice Location

Address: 3001 WARRIOR LN
City: Poplar Bluff
State: Missouri
ZIP Code: 63901-8685
Phone: (573) 686-1200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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