Individual
MR. DANIEL CALVIN HENSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
550 W 121ST ST S, GLENPOOL, OK 74033-8677
(918) 291-5200
(918) 291-5929
Mailing address
550 W 121ST ST S, GLENPOOL, OK 74033-8677
(918) 291-5200
(918) 291-5929
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-239
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200250520A
—
OK
Enumeration date
05/20/2008
Last updated
01/02/2015
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