Provider Demographics
NPI:1821859778
Name:DAVISON, ISAAC (DC)
Entity Type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:DAVISON
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 1:1598 E US STATE ROUTE 36
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078
Mailing Address - Country:US
Mailing Address - Phone:937-653-5353
Mailing Address - Fax:
Practice Address - Street 1:1598 E US STATE ROUTE 36
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-4307
Practice Address - Country:US
Practice Address - Phone:937-653-5353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH05323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor