Individual
DR. HALLIE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
7855 MOFFETT RD, SEMMES, AL 36575-5411
(251) 649-7752
Mailing address
293 MOODY RD, LUCEDALE, MS 39452-8778
(601) 947-3250
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
R-149 TA-684
AL
Other
Enumeration date
10/16/2006
Last updated
07/08/2007
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