Individual
ERIC HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6600 VAN AALST BLVD, FORT MOORE, GA 31905-2102
(762) 408-3107
Mailing address
4926 CEDAR RIDGE CT, COLUMBUS, GA 31909-2081
(706) 577-1123
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1127699
TX
Other
Enumeration date
08/10/2023
Last updated
08/15/2023
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