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NPI Code Detail

MEDICARE: VIRGINIA K HENDERSON PT

MEDICARE: VIRGINIA K HENDERSON PT
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 Therapist1134310TX

General Provider Information

NPI Number : 1457316549
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIRGINIA K HENDERSON PT
Provider Business Mailing Address
First Line : 209 SPEIGHT AVE
Second Line :
City : WACO
State : TX
Zip : 76706-1507
Country : US
Telephone Number : 254-710-1010
Fax Number : 254-710-2499
Provider Business Practice Location Address
First Line : 209 SPEIGHT AVE
Second Line :
City : WACO
State : TX
Zip : 76706-1507
Country : US
Telephone Number : 254-710-1010
Fax Number : 254-710-2499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2006
Last Update Date : 07/08/2007

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Directions to “ VIRGINIA K HENDERSON PT” Practice Location

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