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1710510185
WINSTON D DAVENPORT
CORVALLIS, OR
NPI
1710510185
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: OR AT-AT-10171037)
Enumeration Date
2020-02-13
Last Update Date
2020-02-13
Business Address
Mr. WINSTON D DAVENPORT ATC
325 VALLEY FOOTBALL CTR
CORVALLIS, OR 97331-8544
Phone number: 541-243-4004
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Mailing Address
Mr. WINSTON D DAVENPORT ATC
1597 NW TERRACEGREEN PL
CORVALLIS, OR 97330-1347
Phone number: 541-243-4004
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