Most Relevant Information
Provider Data
| NPI Number: | 1003411455 |
| Provider Name: | MIKEL WAYNE DAVIS |
| Entity Type: | Individual |
| Taxonomy Code: | 376J00000X |
| Specialty: | Homemaker |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/03/2020 |
| Last Updated: | 12/03/2020 |
Provider Practice Location
1222 MARKET ST
PARKERSBURG
WV
261014323
Practice Location Phone/Fax
| Phone: | 3048655420 |
| Fax: | 3048655423 |
Provider Mailing Location
115 1/2 W MAIN ST
PADEN CITY
WV
261591425
Provider Mailing Phone/Fax
| Phone: | 3043378587 |
| Fax: | 3044712488 |