JAKE COBURN DAVIS

RICHFIELD, UT
NPI1841824521
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224P00000X Prosthetist
(Licence:   CPO04745)
Additional Taxonomies222Z00000X Orthotist
(Licence:   CO005925)
Enumeration Date2020-03-03
Last Update Date2022-11-14
Business Address
JAKE COBURN DAVIS CPO, MSPO
635 N MAIN ST STE 691
RICHFIELD, UT 84701-1895
Phone number: 801-820-0087
Mailing Address
JAKE COBURN DAVIS CPO, MSPO
635 N MAIN ST STE 691
RICHFIELD, UT 84701-1895
Phone number: 801-820-0087