Individual
JEROMY EARNEST HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
284 FOREST PARK CIR, PANAMA CITY, FL 32405-4921
(850) 347-4551
Mailing address
113 COVINGTON ST, PANAMA CITY BEACH, FL 32413-2846
(850) 866-2173
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA20208
FL
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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