Richard Henderson OD

NPI 1669537528 - Optometrist - 152W00000X

NPI Details
NPI 1669537528
Gender Male
Enumeration Date 12/22/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1609 N DIXIE HWY
ELIZABETHTOWN KY, 42701-6473, US
Phone (270) 765-7372
Fax (270) 737-3936
Business Location
11103 WEST AVE
SUITE 6
SAN ANTONIO TX, 78213-1370, US
Phone (210) 524-6663
Fax (210) 524-6587
Toxanomy
Taxonomy Code 152W00000X
License State Kentucky
License Number 1217DT
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According to our database, Richard Henderson OD NPI is 1669537528, taxonomy code is 152W00000X and license number is 1217DT, license state is located at Kentucky. Richard Henderson OD physically located at 1609 N Dixie Hwy, Elizabethtown KY, 42701-6473. NPI Number Richard Henderson OD has the Individual type.

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1669537528 NPI number is provided on an as is basis without warranty of any kind. 1669537528 is maintained by the National Plan & Provider Enumeration System. The contents of Richard Henderson OD are for informational purposes only.