| NPI | 1912036385 |
|---|---|
| Former Legal Business Name | DR. RICHARD D. DAVIDSON |
| Entity Type | Organization |
| Authorized Contact | RICHARD D. DAVIDSON Owner 217-253-5216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 019016030) |
| Enumeration Date | 2007-03-03 |
| Last Update Date | 2020-08-22 |