Individual
MELISSA M DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
167 E 1ST S, RIGBY, ID 83442-1401
(208) 745-8747
(208) 745-9396
Mailing address
167 E 1ST S, RIGBY, ID 83442
(208) 745-8747
(208) 745-9396
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
04/11/2012
Last updated
04/11/2012
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