Individual
PAUL GLENN HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2506 DANVILLE RD SW, SUITE 200, DECATUR, AL 35603-4232
(256) 350-6331
(256) 350-1990
Mailing address
1908 FLINT RD SE, DECATUR, AL 35601-6031
(256) 350-1764
(256) 350-7757
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH603
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003819608
GROUP NPI
AL
05
—
529917620
—
AL
Enumeration date
07/26/2006
Last updated
10/01/2012
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