Doctor Name: | MR. CLIFFORD G DAVIS |
NPI Number: | 1467604983 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 2705-089910 |
Business Practice Address: | 26 Mount Sidney School Ln Apt. 104 Mount Sidney, VA - 244672523 |
Business Phone Number: | 5402922447 |
Business Fax Number: | |
Mailing Address: | 26 Mount Sidney School Ln, Apt. 104 MOUNT SIDNEY |
State: | VA |
Postal Code: | 244672523 |
Phone Number: | 5402922447 |
Fax Number: | |
NPI Enumeration Date: | 10/15/2008 |
NPI Last Update Date: | 10/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171WH0202X |
License Number: | 2705-089910 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | Home Modifications |
Taxonomy Definition: |