Individual
DR. BRYAN KENT HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3925 N GATEWAY DR, APPLETON, WI 54913-7863
(920) 454-8401
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10094314-1205
UT
207Q00000X
Family Medicine Physician
Primary
69375-20
WI
Other
Enumeration date
04/02/2015
Last updated
08/10/2021
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