Individual
JUSTICE KERISSA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10816 CORY ST, MANVEL, TX 77578-5544
(832) 812-0810
Mailing address
10816 CORY ST, MANVEL, TX 77578-5544
(832) 812-0810
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
39017504
TX
Other
Enumeration date
05/09/2024
Last updated
05/09/2024
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