Individual
MS. BRENDA DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3244 LORIMAR LN, SAINT CLOUD, FL 34772-6503
(407) 957-7694
Mailing address
3244 LORIMAR LN, SAINT CLOUD, FL 34772-6503
(407) 957-7694
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 52729
FL
Other
Enumeration date
10/04/2010
Last updated
10/04/2010
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