Individual
MR. HENDERSON WILBORN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4466 ELVIS PRESLEY BLVD, SUITE 115, MEMPHIS, TN 38116
(907) 808-3279
(901) 671-1121
Mailing address
PO BOX 3479, MEMPHIS, TN 38173
(901) 808-3279
(901) 671-1121
Taxonomy
Speciality
Code
Description
License number
State
247000000X
Health Information Technician
Primary
44D2067576
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264040069
—
TN
Enumeration date
11/12/2013
Last updated
07/21/2022
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