Individual
JOHN WILLIAM HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
7473 SHAY LN, SOUTH WEBER, UT 84405-9202
(801) 475-7508
Mailing address
7473 SHAY LN, SOUTH WEBER, UT 84405-9202
(801) 475-7508
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
6952002-4810
UT
Other
Enumeration date
03/07/2010
Last updated
03/07/2010
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