Individual
JEANNIE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
320 PENDLETON ST, WAYCROSS, GA 31501-3731
(912) 590-2549
Mailing address
320 PENDLETON ST, WAYCROSS, GA 31501-3731
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
Primary
493758
GA
Other
Enumeration date
05/06/2014
Last updated
05/06/2014
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