Individual
MRS. KRISTI DAWN MASON DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
585 INTERSTATE DR, MANCHESTER, TN 37355-3190
(931) 723-7159
Mailing address
213 CUNNINGHAM FORD RD, ROCK ISLAND, TN 38581-3032
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3883
TN
Other
Enumeration date
11/07/2006
Last updated
01/26/2009
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