Individual
JERRY HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 E FRANKLIN ST, FARMERVILLE, LA 71241-2956
(318) 368-8340
Mailing address
201 E FRANKLIN ST, FARMERVILLE, LA 71241-2956
(318) 368-8340
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
109401
LA
Other
Enumeration date
03/22/2016
Last updated
03/22/2016
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