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1205443058
CLINTON DAVIS
KINGSPORT, TN
NPI
1205443058
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: TN 28302)
Enumeration Date
2020-09-25
Last Update Date
2020-09-25
Business Address
CLINTON DAVIS APRN, PMHNP
1025 EXECUTIVE PARK BLVD
KINGSPORT, TN 37660-4620
Phone number: 423-830-8110
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Mailing Address
CLINTON DAVIS APRN, PMHNP
458 HUNTERS CROSSING LN
KINGSPORT, TN 37664-5453
Phone number: 423-341-4475
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