Individual
ETHEL M HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10692 CRESTWOOD DR STE B, MANASSAS, VA 20109-4410
(703) 368-9131
(703) 368-2038
Mailing address
10692 CRESTWOOD DR STE B, MANASSAS, VA 20109-4410
(703) 368-9131
(703) 368-2038
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110840684
VA
Other
Enumeration date
11/13/2008
Last updated
11/13/2008
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