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Individual

JOSEPH RAND DAVENPORT II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
37 COLLEGE AVE, GORHAM, ME 04038-1032
(207) 780-5659
Mailing address
254 DANFORTH ST APT 3, PORTLAND, ME 04102-5130
(207) 210-8515

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
09/18/2018
Last updated
09/18/2018
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