Individual
ANDREA J HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5255 W OVERLAND RD, BOISE, ID 83705-2637
(208) 338-9486
(208) 338-0171
Mailing address
5255 W OVERLAND RD, BOISE, ID 83705-2637
(208) 338-9486
(208) 338-0171
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-3535
ID
Other
Enumeration date
06/30/2014
Last updated
12/27/2016
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