DR. Charles L Davenport JR.

NPI #1104038686 in Mableton, Georgia

Provider Information

NPI Number
1104038686
Entity Type
Individual
Name
DR. Charles L Davenport JR.
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Pharmacist
Enumeration Date
May 4, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
558 IVEY WAY S.E.
State
Georgia
ZIP Code
30126
Phone
(678) 575-8701

Specialties & Taxonomy Codes

Specialty
Pharmacist

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