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PATRICIA W HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
PARTRICIA W HENDERSON DO PC, 1 ARH LANE, STE. 800, LOW MOOR, VA 24457
(540) 862-6750
(540) 862-3742
Mailing address
PO BOX 629, CLIFTON FORGE, VA 24422-0629
(540) 862-6659
(540) 862-3742

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102037111
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0053573000
WV
05
1316942451
VA
01
260538432
TRICARE
Enumeration date
06/16/2005
Last updated
08/12/2008
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