Provider Demographics
NPI:1164734042
Name:DAVENPORT, ABBY JEAN (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:JEAN
Last Name:DAVENPORT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:ABBY
Other - Middle Name:JEAN
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:216 HIGHLAND AVE STE B
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-2558
Mailing Address - Country:US
Mailing Address - Phone:740-439-7177
Mailing Address - Fax:740-432-1053
Practice Address - Street 1:216 HIGHLAND AVE STE B
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-2558
Practice Address - Country:US
Practice Address - Phone:740-439-7177
Practice Address - Fax:740-432-1053
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.012672225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist