Individual
MR. CHARLES MONTGOMERY HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1111 GLYNCO PKWY STE 110, BRUNSWICK, GA 31525-7922
(912) 264-5377
Mailing address
239 WELLINGTON PL, BRUNSWICK, GA 31523-7075
(912) 262-6650
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT008435
GA
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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