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Individual

MS. ALICIA HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC, OTC

Contact information

Practice address
2045 PEACHTREE RD NE, STE 700, ATLANTA, GA 30309-1414
(404) 355-0743
Mailing address
2045 PEACHTREE RD NE, STE 700, ATLANTA, GA 30309-1414
(404) 355-0743

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT001429
GA
246ZS0410X
Surgical Technologist
Primary
GA

Other

Enumeration date
08/14/2007
Last updated
07/12/2011
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