Individual
MS. MARY GWEN DAVENPORT IX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
COMDT CG-1122 US COAST GUARD, 2100 2ND ST SW, SUITE 5314, WASHINGTON, DC 20593-0001
(671) 355-4885
(671) 355-4928
Mailing address
USCGC SEQUOIA WLB 215, VICTOR WHARF PIER THREE, FPO, AP 96678- 3922
(671) 355-4885
3554928
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
03/26/2007
Last updated
04/20/2008
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