# METRO PROVIDERS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dynamic Medical & Rehab
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811152713
- **Authorized official:** DR. MARK T HENDERSON MD (OWNER)
- **Authorized official phone:** (502) 426-9200

## Contact information

- **Practice address:** 3707 CHAMBERLAIN LN, SUITE 101, LOUISVILLE, KY 40241-2001
- **Practice address phone:** (502) 426-9200
- **Practice address fax:** (502) 426-9259
- **Mailing address:** 3707 CHAMBERLAIN LN, SUITE 101, LOUISVILLE, KY 40241-2001
- **Mailing address phone:** (502) 426-9200
- **Mailing address fax:** (502) 426-9259

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 4390 | KY | — |
| 208D00000X | General Practice Physician | 33009 | KY | Yes |

## Other

- **Enumeration date:** 07/21/2008
- **Last updated:** 09/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 64330095 | — | KY |