Individual
TREMELL DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1515 NE LAWRIE TATUM RD, LAWTON, OK 73507-3002
(580) 354-5270
Mailing address
1515 NE LAWRIE TATUM RD, LAWTON, OK 73507-3002
(580) 354-5270
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
103405
OK
Other
Enumeration date
04/21/2017
Last updated
04/21/2017
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