NPI 1114528973
Davis Jackson Medical Assist Tean Lee
Practice location
- Address
- 6449 Ipth Dr., Saint Paul, MN 55725-1130
- Phone
- (657) 592-5960
- Fax
- (651) 286-2994
- Mailing address
- 1321 E. 78th Street APT. 114, Bloomington, MN 55425-1114
Authorised official
- Name
- Florense Monique Davis
- Title
- President/Owner
- Phone
- (651) 595-5960
Registered specialties (5)
Adult Companion
Primary
Chore Provider
Day Training/Habilitation Specialist
Personal Care Attendant
Homemaker
Registry record
- NPI
- 1114528973
- Entity type
- Organization
- NPI issued
- 6 Nov 2020
- Record last updated
- 6 Nov 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.