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Individual

CHRISTOPHER R HENDERSON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
14335 BRAILE ST, DETROIT, MI 48223-2721
(734) 639-9791
Mailing address
14335 BRAILE ST, DETROIT, MI 48223-2721
(734) 639-9791

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000000000
MI
Enumeration date
12/12/2022
Last updated
12/12/2022
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