Individual
SKYLER M DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
420 S FULTON ST, BUTLER, MO 64730
(660) 424-3226
Mailing address
310 S THOMPSON ST, BUTLER, MO 64730
(660) 424-3226
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2017035035
MO
Other
Enumeration date
02/09/2019
Last updated
02/09/2019
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