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General NPI Number Information
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NPI Number | 1396345807
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Entity Type | Individual
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Provider Name | DAREN LAYNE DAVENPORT
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Gender | Male
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Dates
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Enumeration Date | 10/26/2020
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 745 W HILL FIELD RD
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City | LAYTON
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State | UT
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Zip | 84041-4602
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Country | US
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Telephone | 801-546-1993
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Fax |
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Provider Business Mailing Address
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Address Line | 1354 W FOREST CREEK LN
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City | LAYTON
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State | UT
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Zip | 84041-5284
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Country | US
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Telephone | 801-589-5012
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 275686-1701
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License Number State | UT
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