MEDICARE: JODY HENDRYX

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	225100000X	Physical Therapist	4285	AZ

General Provider Information

NPI Number	:	1902800923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JODY HENDRYX

Provider Business Mailing Address
First Line	:	55 MANZANITA DR
Second Line	:
City	:	SEDONA
State	:	AZ
Zip	:	86336-4053
Country	:	US
Telephone Number	:	512-789-9467
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 MANZANITA DR
Second Line	:
City	:	SEDONA
State	:	AZ
Zip	:	86336-4053
Country	:	US
Telephone Number	:	512-789-9467
Fax Number	:

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

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	12/21/2019

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Directions to “ JODY HENDRYX ” Practice Location

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