Provider Demographics
NPI:1871142349
Name:DAVIS, DONALD RICHARD JR (DC)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:RICHARD
Last Name:DAVIS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:1438 BRAMBLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MO
Mailing Address - Zip Code:63755-1165
Mailing Address - Country:US
Mailing Address - Phone:573-816-3030
Mailing Address - Fax:573-816-3031
Practice Address - Street 1:1438 BRAMBLEWOOD RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MO
Practice Address - Zip Code:63755-1165
Practice Address - Country:US
Practice Address - Phone:573-816-3030
Practice Address - Fax:573-816-3031
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-08
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2019034945111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor