Individual
BOBBY DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1613 5TH ST NW, ALBUQUERQUE, NM 87102-1301
(505) 392-0839
Mailing address
1613 5TH ST NW, ALBUQUERQUE, NM 87102-1301
(505) 392-0839
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00007513
NM
Other
Enumeration date
05/13/2016
Last updated
05/13/2016
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