Individual
JACQUELINE MARIE DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
200 PATEWOOD DR, STE C250, GREENVILLE, SC 29615-3593
(864) 454-0952
Mailing address
103 N MAIN ST, STE 300, GREENVILLE, SC 29601-2796
(864) 528-5700
(864) 528-5701
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6436
SC
Other
Enumeration date
08/19/2011
Last updated
10/13/2017
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