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Andrea Davenport
NPI 1851772529 · on the registry since 2015 · sole proprietor
Practice
- Address
- 17321 Indiana St
Detroit, MI 48221 - Phone
- (313) 420-9633
Registry record
- Primary taxonomy
- Private Vehicle
347C00000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2015-06-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan