Individual
MR. CORY RYAN HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
57950 LEAVENWORTH ST, MCCONNELL AFB, KS 67221-3505
(316) 759-5120
(316) 759-6553
Mailing address
57950 LEAVENWORTH ST, MCCONNELL AFB, KS 67221-3505
(316) 759-5120
(316) 759-6553
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
05/23/2012
Last updated
08/15/2022
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