Individual
PAUL KEITH HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSFA
Contact information
Practice address
101 LORD EFFINGHAM DR, RINCON, GA 31326-5017
(912) 656-1908
Mailing address
101 LORD EFFINGHAM DR, RINCON, GA 31326-5017
(912) 656-1908
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
246ZS0410X
Surgical Technologist
—
—
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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