Jake Coburn Davis, CPO, MSPO

NPI #1841824521 in Richfield, Utah

Provider Information

NPI Number: 1841824521
Entity Type: Individual
Name: Jake Coburn Davis, CPO, MSPO
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Prosthetist
Credential: CPO, MSPO
Enumeration Date: Mar 3, 2020
Last Updated: Nov 14, 2022

Practice Location

Address: 635 N MAIN ST STE 691
City: Richfield
State: Utah
ZIP Code: 84701-1895
Phone: (801) 820-0087

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthotist	222Z00000X
Prosthetist	224P00000X	Primary

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