Individual
MARQUITA HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 GOOSEBERRY HL, SHREVEPORT, LA 71118-3508
(318) 658-3528
Mailing address
1101 GOOSEBERRY HL, SHREVEPORT, LA 71118-3508
(318) 658-3528
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
31134
LA
Other
Enumeration date
03/20/2018
Last updated
03/20/2018
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