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Organization
LORETTA V HENDERSON DPM
Active
Organization
LORETTA V HENDERSON DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA V HENDERSON DPM (PROPRIETOR)
(866) 365-3668
Entity
Organization
Contact information
Practice address
1543 ALDERSGATE DR, KISSIMMEE, FL 34746-6545
(866) 365-3668
(407) 870-7753
Mailing address
PO BOX 720849, ORLANDO, FL 32872-0849
(866) 365-3668
(407) 870-7753
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PO1685
FL
Other
Enumeration date
12/23/2008
Last updated
12/23/2008
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