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Individual

MR. HAROLD LENARD HENDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC/LAT

Contact information

Practice address
93 PANTHER PAWS TRL, KISSIMMEE, FL 34744-4407
(407) 935-3600
(407) 935-3609
Mailing address
302 OAK BLVD, WILDWOOD, FL 34785-9223
(352) 748-4655
(407) 935-4609

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 1597
FL

Other

Enumeration date
07/20/2006
Last updated
07/08/2007
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