Kathy A Henricksen DPM

NPI 1770795650 - Podiatrist - 213E00000X

NPI Details
NPI 1770795650
Gender Female
Enumeration Date 05/04/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
512 E KINGSTON AVE
CHARLOTTE NC, 28203-5118, US
Phone (704) 841-4000
Fax (704) 841-4338
Business Location
PO BOX 2793
MATTHEWS NC, 28106-2793, US
Phone (704) 841-4000
Fax (704) 841-4338
Toxanomy
Taxonomy Code 213E00000X
License State North Carolina
License Number 377
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According to our database, Kathy A Henricksen DPM NPI is 1770795650, taxonomy code is 213E00000X and license number is 377, license state is located at North Carolina. Kathy A Henricksen DPM physically located at 512 E Kingston Ave, Charlotte NC, 28203-5118. NPI Number Kathy A Henricksen DPM has the Individual type.

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1770795650 NPI number is provided on an as is basis without warranty of any kind. 1770795650 is maintained by the National Plan & Provider Enumeration System. The contents of Kathy A Henricksen DPM are for informational purposes only.