Individual
JADE DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11101 HEFNER POINTE DR STE 207, OKLAHOMA CITY, OK 73120-5054
(405) 720-9812
Mailing address
4219 S WESTERN AVE, OKLAHOMA CITY, OK 73109-3410
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5732
OK
Other
Enumeration date
02/07/2020
Last updated
02/07/2020
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