Individual
TARA B. HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
61 WHITCHER ST NE, SUITE 1150, MARIETTA, GA 30060-1176
(678) 594-4250
(770) 423-2166
Mailing address
61 WHITCHER ST NE, SUITE 1150, MARIETTA, GA 30060-1176
(678) 594-4250
(770) 423-2166
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT008617
GA
Other
Enumeration date
03/02/2006
Last updated
01/25/2012
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