Provider Demographics
NPI:1417793118
Name:DAVIS, DANIEL LAWRENCE SR
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:LAWRENCE
Last Name:DAVIS
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5986 SUNRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-2738
Mailing Address - Country:US
Mailing Address - Phone:513-652-4071
Mailing Address - Fax:
Practice Address - Street 1:5986 SUNRIDGE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-2738
Practice Address - Country:US
Practice Address - Phone:513-652-4071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle