Individual
ERICA DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
704 N HAMILTON ST, GEORGETOWN, KY 40324-1829
(754) 303-4622
Mailing address
3792 SUNDART DR, LEXINGTON, KY 40517-3852
(754) 303-4622
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
KY
Other
Enumeration date
12/29/2022
Last updated
12/29/2022
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