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1932672979
JACOB DAVIS
BATON ROUGE, LA
NPI
1932672979
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
302R00000X Health Maintenance Organization
(Licence: LA 5559)
Enumeration Date
2019-01-02
Last Update Date
2019-01-02
Business Address
JACOB DAVIS
606 COLONIAL DR STE B
BATON ROUGE, LA 70806-6535
Phone number: 225-406-7670
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Mailing Address
JACOB DAVIS
606 COLONIAL DR STE B
BATON ROUGE, LA 70806-6535
Phone number: 225-406-7670
Copy
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