Individual
TAMARA JOY HENDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ABO, NCLE
Contact information
Practice address
11505 ULYSSES ST NE # B, BLAINE, MN 55434-4239
(763) 354-5399
Mailing address
11505 ULYSSES ST NE, BLAINE, MN 55434-4239
(763) 354-5399
(763) 862-8742
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
05/18/2023
Last updated
05/18/2023
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