Individual
MRS. RENEE DENISE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14534 REDFORD DR, STERLING HEIGHTS, MI 48312-5763
(313) 303-6445
Mailing address
14534 REDFORD DR, STERLING HEIGHTS, MI 48312-5763
(313) 303-6445
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
MEDICARE FOR DME
MI
Enumeration date
11/30/2017
Last updated
11/30/2017
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