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Individual

DENIECE DAVENPORT OATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC, LATC

Contact information

Practice address
110 INDOOR PRACTICE FACILITY BRIGHAM, PROVO, UT 84602-2000
(801) 422-3450
Mailing address
87 E 710 N, LINDON, UT 84042-1325
(801) 755-9304

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
129402406
UT

Other

Enumeration date
01/26/2023
Last updated
01/26/2023
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