Organization
KAROL J HENDRICKSON DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA R MOORE (CREDENTIALING SPECIALIST)
(734) 207-5226
Entity
Organization
Contact information
Practice address
4669 12TH RD, ESCANABA, MI 49829-9605
(906) 786-9391
Mailing address
4669 12TH RD, ESCANABA, MI 49829-9605
(906) 786-9391
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
5101012173
MI
Other
Enumeration date
06/29/2009
Last updated
07/30/2009
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