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Individual

KENNETH JOSEPH DAVENPORT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
21931 MARIAN CIR, FAIRVIEW PARK, OH 44126-2618
(440) 781-9993
Mailing address
21931 MARIAN CIR, FAIRVIEW PARK, OH 44126-2618
(440) 781-9993

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Enumeration date
12/16/2024
Last updated
01/06/2025
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