Individual
PATRICIA A HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
744 E ATWATER AVE, BLOOMINGTON, IN 47401-3634
(812) 855-8436
Mailing address
744 E ATWATER AVE, BLOOMINGTON, IN 47401-3634
(812) 855-8436
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002170
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100184400
—
IN
05
—
2275916
—
OH
Enumeration date
03/17/2006
Last updated
01/12/2026
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