Individual
JASON HENDERSHOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1225 WOODLAND DR, THERAPY DEPT, MT ZION, IL 62549-1237
(217) 864-2356
Mailing address
1225 WOODLAND DR, THERAPY DEPT, MT ZION, IL 62549-1237
(217) 864-2356
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.001330
IL
Other
Enumeration date
08/07/2014
Last updated
08/07/2014
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