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1265681084
CHARLES DAVIS
RUSSELLVILLE, AR
NPI
1265681084
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2008-09-17
Last Update Date
2008-09-17
Business Address
-- CHARLES DAVIS
110 SKYLINE DR
RUSSELLVILLE, AR 72801-3362
Phone number: 479-968-1298
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Mailing Address
-- CHARLES DAVIS
1400 E 16TH ST
RUSSELLVILLE, AR 72802-2648
Phone number: 479-967-1397
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