Individual
MISS KRYSTAL MARIE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
395 W 12TH AVE STE 662, COLUMBUS, OH 43210-1267
(614) 293-8704
Mailing address
3900 RESERVOIR RD NW, WASHINGTON, DC 20007-2126
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
57.256856
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2023
Last updated
04/30/2024
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