Individual
LISA LYNN HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1902 59TH ST W, BRADENTON, FL 34209-4602
(941) 761-1000
(941) 761-1009
Mailing address
364 STRATHAVEN DR, PELHAM, AL 35124-6282
(817) 917-0040
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
31390
FL
Other
Enumeration date
08/26/2021
Last updated
08/26/2021
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