Individual
RENO ZACHERY DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2488 DE LA CRUZ BLVD, SANTA CLARA, CA 95050-2923
(408) 247-7278
Mailing address
1050 BIRD AVE, SAN JOSE, CA 95125-1617
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
50488
CA
Other
Enumeration date
12/05/2021
Last updated
12/05/2021
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