Individual
MELISSA SUZANN DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
112 HEALTH CARE DR, CARTHAGE, TN 37030-1168
(615) 735-0569
Mailing address
669 TRAMMEL RD, LEBANON, TN 37090-0778
(615) 969-3375
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
02937
TN
Other
Enumeration date
06/14/2011
Last updated
06/14/2011
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