MACKENZIE DAVENPORT

GRAND RAPIDS, MI
NPI1427595842
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MI  2601002811)
Additional Taxonomies2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: CO  AT.0002319)
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN  36003148A)
Enumeration Date2017-01-24
Last Update Date2023-11-16
Business Address
MACKENZIE DAVENPORT AT, ATC
6191 KRAFT AVE SE
GRAND RAPIDS, MI 49512-9396
Phone number: 616-871-6738
Mailing Address
MACKENZIE DAVENPORT AT, ATC
6130 WOODFIELD DR SE APT 2
GRAND RAPIDS, MI 49548-8516
Phone number: 574-274-6598