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General NPI Number Information
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NPI Number | 1922490416
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Entity Type | Individual
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Provider Name | MIRANDA DAVIS NPA, CPT
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Gender | Female
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Dates
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Enumeration Date | 02/20/2015
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Last Update Date | 12/30/2015
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Provider Practice Location Address
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Address Line | 42383 GARFIELD RD UNIT 381286
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-7742
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Country | US
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Telephone | 844-727-2011
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Fax | 586-421-4842
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Provider Business Mailing Address
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Address Line | 42383 GARFIELD RD UNIT 381286
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-0079
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Country | US
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Telephone | 313-903-8830
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Fax | 586-421-4842
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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