Kizzy L Davis

Individual provider Active NPI Contractor · Columbia, SC

NPI 1558083352 · NPPES record last updated Sep 19, 2022

Key facts

NPI
1558083352
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
Practice address
3615 Percival Rd Lot 75
Columbia, SC 29223-4275
Phone
(803) 667-5888
NPI assigned
Sep 19, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Yes

Addresses

Primary practice location

3615 Percival Rd Lot 75
Columbia, SC 29223-4275

Mailing address

4464 Devine St Ste 1241M
Columbia, SC 29205-3605
Phone (803) 667-5888

Other providers in Columbia, SC

All providers in Columbia, SC · Contractor in South Carolina

Sources for this page

Verify at the official NPI Registry.