JOHNNY (BLAINE) HENDERSON

FLAGSTAFF, AZ
NPI1659492627
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: AZ  48599)
Enumeration Date2007-04-03
Last Update Date2015-12-18
Business Address
JOHNNY (BLAINE) HENDERSON MD
1200 N BEAVER ST
FLAGSTAFF, AZ 86001-3118
Phone number: 928-213-6415
Mailing Address
JOHNNY (BLAINE) HENDERSON MD
1200 N BEAVER ST PAYER CREDENTIALING
FLAGSTAFF, AZ 86001-3118
Phone number: 928-773-2559
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