Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1928 | MA |
NPI | 1003903063 |
---|---|
Provider Name | Dr. Todd Owen Davis |
First Address | Westminster, MA 01473-1606 |
Second Address | Westminster, MA 01473-1606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2006 |
Last Update Date | 08/07/2007 |