Individual
MICHAEL G HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
450 WILLIAMS WAY, MOAB, UT 84532-2185
(435) 719-3500
Mailing address
500 S MAPLE ST, WACONIA, MN 55387-1791
(952) 442-2191
(952) 442-8055
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
288380-1206
UT
Other
Enumeration date
11/04/2005
Last updated
11/10/2020
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