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Individual
MARILYN C HENDERSON
Active
Individual
MARILYN C HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC002642L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1681042
—
PA
Enumeration date
02/01/2006
Last updated
07/08/2007
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