Organization
RODNEY D. HENSON
Active
Other names
Henson Orthotic & Prosthetic Ent
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODNEY DOUGLAS HENSON CPO 02313 (OWNER)
(209) 944-9990
Entity
Organization
Contact information
Practice address
2540 PACIFIC AVE, SUITE 2B, STOCKTON, CA 95204-4400
(209) 944-9990
(209) 944-9992
Mailing address
2540 PACIFIC AVE, SUITE 2B, STOCKTON, CA 95204-4400
(209) 944-9990
(209) 944-9992
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XC0023130
—
CA
Enumeration date
09/23/2005
Last updated
09/08/2015
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