Provider Demographics
NPI:1376845271
Name:DAVIS, MARGARET J (L AC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:J
Last Name:DAVIS
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53094-4901
Mailing Address - Country:US
Mailing Address - Phone:404-543-6114
Mailing Address - Fax:
Practice Address - Street 1:206 S SILVER LAKE ST
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-3723
Practice Address - Country:US
Practice Address - Phone:920-474-6218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-27
Last Update Date:2010-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI690-055171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist