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Individual

DR. JESSICA ANN HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
3450 COBB PKWY NW STE 220, ACWORTH, GA 30101-8352
(770) 974-1978
Mailing address
6397 LEE HWY STE 300, CHATTANOOGA, TN 37421-4915

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
10130
NC
225100000X
Physical Therapist
5722
SC
225100000X
Physical Therapist
Primary
PT012429
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7211905
NC
Enumeration date
10/02/2006
Last updated
08/11/2021
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