Kirk Wagner Davis
Kirk Wagner Davis is a Student in an Organized Health Care Education/Training Program in Park Ridge, Illinois. Practices as a sole proprietor. Registered with an NPI since 2025.
- In the registry since
- 2025
Practice location Address checks out
1110 S Washington AvePark Ridge, IL 60068-4815
Phone: (773) 497-9417
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1679462543 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | July 2, 2025 |
| Last updated in NPPES | July 2, 2025 |
| Certification date | July 1, 2025 |
| Mailing address | 1110 S Washington Ave, Park Ridge, IL 60068-4815 |
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