Individual
AMBER NOEL DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
245 W CENTRE AVE, PORTAGE, MI 49024-5331
(269) 323-2450
Mailing address
825 N CENTER AVENUE, GAYLORD, MI 49735
(989) 731-7708
(989) 731-7929
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601006455
MI
Other
Enumeration date
09/18/2012
Last updated
04/02/2020
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