Individual
HENRIETTA AJAYI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2117 W AIRPORT FWY STE 19, IRVING, TX 75062-6070
(972) 870-0002
Mailing address
2117 W AIRPORT FWY STE 19, IRVING, TX 75062-6070
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
236801
TX
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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