Individual
CRYSTAL HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
930 BARACHEL LN STE 400, GREENSBURG, IN 47240-3253
(812) 663-5072
(812) 662-6619
Mailing address
321 W BRUCE ST STE B, PO BOX 1192, SEYMOUR, IN 47274-2319
(812) 522-7887
(812) 522-7326
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05004775A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000329061
INDIVIDUAL BCBS NUMBER
IN
05
—
100140690
—
IN
Enumeration date
02/12/2007
Last updated
02/16/2010
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