Individual
STEPHANIE TERRELL HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
313 REVOLUTION DR, PEACHTREE CITY, GA 30269-1086
(252) 342-5772
Mailing address
313 REVOLUTION DR, PEACHTREE CITY, GA 30269-1086
(252) 342-5772
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9474
GA
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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