Individual
MRS. KATHY MARIE HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
110 9TH AVE S, CARRINGTON, ND 58421-2020
(701) 652-2020
(701) 652-2942
Mailing address
110 9TH AVE S, CARRINGTON, ND 58421-2020
(701) 652-2020
(701) 652-2942
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
578
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60529
—
ND
Enumeration date
02/20/2006
Last updated
12/26/2007
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