Provider Demographics
NPI:1992250864
Name:DAVIS, ERIC (LMT)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:DAVIS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 MAIN ST
Mailing Address - Street 2:SUITE NUMBER 2
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7464
Mailing Address - Country:US
Mailing Address - Phone:716-341-5911
Mailing Address - Fax:
Practice Address - Street 1:8600 MAIN ST
Practice Address - Street 2:SUITE NUMBER 2
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7464
Practice Address - Country:US
Practice Address - Phone:716-341-5911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027922111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor