Jesse Davis
Phlebology in Mentor, OH. Individual provider (NPI-1).
NPI number1013623842
StatusActive
Last updated in NPPESApr 25, 2023
Details
- NPI
- 1013623842
- Entity type
- Individual (NPI-1)
- Name
- Jesse Davis
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 25, 2023
- Certification date
- Apr 25, 2023
- Last updated
- Apr 25, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 202K00000X | Phlebology | FAT2P469 | OH | Yes |
Practice location
7232 Justin WayMentor, OH 44060-4881
Phone 440-578-8200
Mailing address
7232 Justin WayMentor, OH 44060-4881
Phone 440-578-8200
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