Individual
MR. JOEL BRENT HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1206 N TRAVIS ST, LIBERTY, TX 77575-3540
(936) 336-7247
Mailing address
411 WALNUT ST, #8650, GREEN COVE SPRINGS, FL 32043-3443
(864) 353-9467
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2081113
TX
Other
Enumeration date
05/22/2012
Last updated
05/22/2012
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