Individual
NICARRO HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2005 E DAWSON RD, ALBANY, GA 31707
(229) 809-7246
Mailing address
2005 E DAWSON RD, ALBANY, GA 31707
(229) 809-7246
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
CO102526
GA
332B00000X
Durable Medical Equipment & Medical Supplies
CO102526
GA
332BC3200X
Customized Equipment (DME)
Primary
CO102526
GA
Other
Enumeration date
01/20/2017
Last updated
04/03/2019
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