NPI | 1629349857 |
---|---|
Former Legal Business Name | DR GARY E DAVIDSON, OD |
Entity Type | Organization |
Authorized Contact | GARY E DAVIDSON President 502-895-4456 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: KY 0886DT) |
Enumeration Date | 2012-01-19 |
Last Update Date | 2012-01-19 |