Provider Demographics
NPI:1275671042
Name:DAVIS, FLOYD JEROME (DC)
Entity Type:Individual
Prefix:
First Name:FLOYD
Middle Name:JEROME
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 931
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:MO
Mailing Address - Zip Code:64601
Mailing Address - Country:US
Mailing Address - Phone:660-646-7246
Mailing Address - Fax:
Practice Address - Street 1:701 LOCUST STREET
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:MO
Practice Address - Zip Code:64601
Practice Address - Country:US
Practice Address - Phone:660-646-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOC005617111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor