Breanna Davenport, MBA, VATL, ATC
Specialist/Technologist, Athletic Trainer in Abingdon, VA. Individual provider (NPI-1).
NPI number1750831764
StatusActive
Last updated in NPPESOct 13, 2016
Details
- NPI
- 1750831764
- Entity type
- Individual (NPI-1)
- Name
- Breanna Davenport
- Credential
- MBA, VATL, ATC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 13, 2016
- Last updated
- Oct 13, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 0126001832 | VA | Yes |
Practice location
812 Thompson DrC/O Bre Davenport
Abingdon, VA 24210-2346
Phone 276-206-6729
Mailing address
10774 Forest Hill DrGlade Spring, VA 24340-5246
Phone 276-206-6729
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