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Individual
SHAWN D DAVENPORT
Active
Individual
SHAWN D DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
70-011513
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36104700
—
WI
Enumeration date
10/19/2006
Last updated
07/08/2007
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