Individual
MR. KEITH JOHN HENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4331 CHURCHMAN AVE, SUITE 102, LOUISVILLE, KY 40215-1164
(502) 366-1773
(502) 366-3500
Mailing address
403 N MILES ST, ELIZABETHTOWN, KY 42701-1834
(270) 360-9129
(270) 234-8197
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004602
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000340690
BLUE CROSS
KY
Enumeration date
01/17/2007
Last updated
07/08/2007
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