Individual
TINA ASHLEY DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 MACK ST, SAINT MATTHEWS, SC 29135-1131
(803) 456-1272
Mailing address
111 MACK ST, SAINT MATTHEWS, SC 29135-1131
(803) 456-1272
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
01/03/2023
Last updated
01/03/2023
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