MEDICARE: LUKE DAVIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	0008864	CO

General Provider Information

NPI Number	:	1891501201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUKE DAVIS

Provider Business Mailing Address
First Line	:	561 25 RD STE 104
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-1360
Country	:	US
Telephone Number	:	970-989-9219
Fax Number	:

Provider Business Practice Location Address
First Line	:	561 25 RD STE 104
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-1360
Country	:	US
Telephone Number	:	970-989-9219
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2024
Last Update Date	:	12/10/2024

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Directions to “ LUKE DAVIS ” Practice Location

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