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Bibomba Davenport
NPI 1679901995 · on the registry since 2013 · sole proprietor
Practice
- Address
- 2690 Mt Wilkinson Pkwy Se
22
Smyrna, GA 30080 - Phone
- (404) 510-2604
Registry record
- Primary taxonomy
- 332B00000X
332B00000X
- Also registered as
- 1744P3200X
335E00000X - Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-05-31
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia