Individual
DR. KATHERINE LYNN HENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1102 E STUART DR, GALAX, VA 24333-2514
(276) 236-4171
(276) 236-0909
Mailing address
1102 E STUART DR, GALAX, VA 24333-2514
(276) 236-4171
(276) 236-0909
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001546
VA
152W00000X
Optometrist
1710
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010236584
—
VA
05
—
010236789
—
VA
05
—
890925L
—
NC
Enumeration date
03/02/2006
Last updated
09/28/2012
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