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Organization
METRO PROVIDERS, PLLC
Active
Organization
METRO PROVIDERS, PLLC
Active
Other names
Dynamic Medical & Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK T HENDERSON MD (OWNER)
(502) 426-9200
Entity
Organization
Contact information
Practice address
3707 CHAMBERLAIN LN, SUITE 101, LOUISVILLE, KY 40241-2001
(502) 426-9200
(502) 426-9259
Mailing address
3707 CHAMBERLAIN LN, SUITE 101, LOUISVILLE, KY 40241-2001
(502) 426-9200
(502) 426-9259
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
4390
KY
208D00000X
General Practice Physician
Primary
33009
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64330095
—
KY
Enumeration date
07/21/2008
Last updated
09/08/2008
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