Individual
DEVAN HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOTR/L
Contact information
Practice address
2020 E 12TH ST, CASPER, WY 82601-4007
(307) 995-1145
(307) 473-1440
Mailing address
2020 E 12TH ST, CASPER, WY 82601-4007
(307) 995-1145
(307) 473-1440
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR-1252
WY
Other
Enumeration date
03/16/2017
Last updated
03/16/2017
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