Individual
IYANA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2205 W BURNHAM ST, MILWAUKEE, WI 53204-3030
(414) 426-7668
Mailing address
2205 W BURNHAM ST, MILWAUKEE, WI 53204-3030
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0017981
WI
Other
Enumeration date
01/12/2022
Last updated
01/12/2022
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