Individual
DESEANDRA CHANICE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
663 JORDAN ST, SHREVEPORT, LA 71101-4748
(318) 222-8892
(318) 222-8893
Mailing address
663 JORDAN ST, SHREVEPORT, LA 71101-4748
(318) 222-8892
(318) 222-8893
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
CP018869T
LA
225100000X
Physical Therapist
PT016263
GA
Other
Enumeration date
10/03/2022
Last updated
05/03/2023
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