Individual
TIFFNEY MARIE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 E 4TH ST, MANCHESTER, OH 45144-1412
(937) 549-4137
Mailing address
401 E 4TH ST, MANCHESTER, OH 45144-1412
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Enumeration date
04/11/2007
Last updated
07/08/2007
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