Individual
DAVID LANCE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
91 BAY BRIDGE DR, GULF BREEZE, FL 32561-4468
(850) 418-9890
Mailing address
6569 CODELL ST, NAVARRE, FL 32566-8128
(850) 240-8578
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
07/26/2016
Last updated
07/26/2016
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