Individual
DESIREE CHERRY-DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9922 BROAD FOREST ST, SAN ANTONIO, TX 78250-3318
(210) 508-9128
Mailing address
9922 BROAD FOREST ST, SAN ANTONIO, TX 78250-3318
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
216116
TX
Other
Enumeration date
11/15/2019
Last updated
11/15/2019
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