Individual
MR. EARL D HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1169 N MAIN ST, ZWOLLE, LA 71486-0608
(318) 645-4640
(318) 645-2209
Mailing address
PO BOX 608, ZWOLLE, LA 71486-0608
(318) 645-4640
(318) 645-2209
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9763
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1250945
—
LA
Enumeration date
10/18/2006
Last updated
06/23/2008
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