Individual
BENJAMIN HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
140 TECHNOLOGY LN, JOHNSON CITY, TN 37604-2004
(423) 434-2016
Mailing address
9096 MOUNTAIN RD, LEBANON, VA 24266-6678
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0000003350
TN
Other
Enumeration date
10/13/2020
Last updated
10/19/2020
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