Individual
MARY H HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
224 N 5TH ST, BRAINERD, MN 56401-3348
(218) 829-4231
(218) 825-3855
Mailing address
17173 PINE CIRCLE RD, BRAINERD, MN 56401-6135
(218) 829-4231
(218) 825-3855
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
550
ND
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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