Individual
DAVIS E HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 E AZTEC AVE, GALLUP, NM 87301-5509
(505) 721-1800
Mailing address
1000 E AZTEC AVE, GALLUP, NM 87301-5509
(505) 721-1800
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
01/11/2008
Last updated
01/11/2008
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