Individual
KIMBERLY R HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1343 S 20TH ST, LOUISVILLE, KY 40210-1601
(502) 294-6898
Mailing address
1343 S 20TH ST, LOUISVILLE, KY 40210-1601
(502) 294-6898
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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