| NPI | 1568148039 |
|---|---|
| Other Name | THAD DAVIS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ OPT-00779) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD61467516) |
| 152W00000X Optometrist (Licence: ID ODP-100630) | |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2024-05-24 |