Individual
MR. PAUL WALTER HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 HOSPITAL ST, BOONEVILLE, MS 38829-3354
(662) 720-5000
Mailing address
195 COUNTY ROAD 1250, BOONEVILLE, MS 38829-7414
(662) 720-6370
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
RCP2642
MS
Other
Enumeration date
04/23/2008
Last updated
04/23/2008
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