Individual
KATHY A HENRICKSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
512 E KINGSTON AVE, CHARLOTTE, NC 28203-5118
(704) 841-4000
(704) 841-4338
Mailing address
PO BOX 2793, MATTHEWS, NC 28106-2793
(704) 841-4000
(704) 841-4338
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
377
NC
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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