Individual
TIMOTHY ALLEN HENDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN-C
Contact information
Practice address
1305 BLUFF ST, HAMBURG, IA 51640-1345
(402) 202-9830
Mailing address
1305 BLUFF ST, HAMBURG, IA 51640-1345
(402) 202-9830
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P36311
IA
Other
Enumeration date
10/21/2011
Last updated
10/21/2011
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