Individual
GRACIE B DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2444 BROAD ST, CHATTANOOGA, TN 37408-2909
(276) 791-1034
Mailing address
4113 INDIGO GLEN LN, CHATTANOOGA, TN 37419-2161
(276) 791-1034
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12171
TN
Other
Enumeration date
03/05/2019
Last updated
10/04/2023
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