Individual
DR. MELISSA A HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D
Contact information
Practice address
2222 W LEXINGTON AVE, ELKHART, IN 46514-1420
(574) 294-3030
(574) 296-3544
Mailing address
PO BOX 2968, ELKHART, IN 46515-2968
(574) 296-3200
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003792A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201201560
—
IN
Enumeration date
06/17/2013
Last updated
07/21/2022
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