Individual
DR. LYNN ANDRE HENRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17 LA AGUAPA, SANDIA PARK, NM 87047-9676
(505) 286-8027
Mailing address
17 LA AGUAPA, SANDIA PARK, NM 87047-9676
(505) 286-8027
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD2005-0215
NM
Other
Enumeration date
12/07/2005
Last updated
01/06/2011
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