Individual
BETTINA LOUISE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 STOKES RD, COLUMBUS, MS 39702-7541
(662) 251-5074
Mailing address
111 STOKES RD, COLUMBUS, MS 39702-7541
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
05/16/2018
Last updated
05/16/2018
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