Individual
LUKE KENTON HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1061 HARMON AVE., FT. STEWART, GA 31314-5674
(912) 435-6633
Mailing address
1061 HARMON AVE., FT. STEWART, GA 31314-5674
(912) 435-6633
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1102083
GA
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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