MEDICARE: CINDY A CRITTENDEN-HENDERSON LDO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician	692	TN

General Provider Information

NPI Number	:	1922132265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY A CRITTENDEN-HENDERSON LDO

Provider Business Mailing Address
First Line	:	5301 HIGHWAY 153
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-4912
Country	:	US
Telephone Number	:	423-877-9990
Fax Number	:	423-875-9952

Provider Business Practice Location Address
First Line	:	5301 HIGHWAY 153
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-4912
Country	:	US
Telephone Number	:	423-877-9990
Fax Number	:	423-875-9952

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	07/08/2007

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Directions to “ CINDY A CRITTENDEN-HENDERSON LDO” Practice Location

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