LANE DAVENPORT

TULSA, OK
NPI1427891829
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2024-06-14
Last Update Date2024-06-14
Business Address
LANE DAVENPORT
1111 W 17TH ST
TULSA, OK 74107
Phone number: 918-429-5603
Mailing Address
LANE DAVENPORT
17019 BROOKLYNN AVE APT 20
TAHLEQUAH, OK 74464-1703
Phone number: