ELIZABETH HENDERSON

ATMORE, AL
NPI1275067969
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy302R00000X Health Maintenance Organization
(Licence: AL  359-052)
Additional Taxonomies302R00000X Health Maintenance Organization
(Licence: FL  M16000003277)
Enumeration Date2017-04-19
Last Update Date2017-04-19
Business Address
-- ELIZABETH HENDERSON
102 W LOUISVILLE AVE
ATMORE, AL 36502-1710
Phone number: 251-359-4480
Mailing Address
-- ELIZABETH HENDERSON
PO BOX 525
ATMORE, AL 36504-0525
Phone number: 251-359-4480