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NPI Code Detail

MEDICARE: MS. GLENYS LOUISE HENDERSON P.T.

MEDICARE: MS. GLENYS LOUISE HENDERSON P.T.
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
1225100000XPhysical Therapist1065CO

General Provider Information

NPI Number : 1265642615
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GLENYS LOUISE HENDERSON P.T.
Provider Business Mailing Address
First Line : 9096 E NASSAU AVE
Second Line :
City : DENVER
State : CO
Zip : 80237-1917
Country : US
Telephone Number : 303-850-9357
Fax Number :
Provider Business Practice Location Address
First Line : 2490 W 26TH AVE STE 220A
Second Line :
City : DENVER
State : CO
Zip : 80211-5385
Country : US
Telephone Number : 720-694-8686
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 12/30/2021

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