Malik Henderson

NPI #1194321000 in Menomonee Falls, Wisconsin

Provider Information

NPI Number: 1194321000
Entity Type: Individual
Name: Malik Henderson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Driver
Enumeration Date: Dec 7, 2020
Last Updated: Dec 7, 2020

Practice Location

Address: N91W16112 JUNCTION WAY APT 304
City: Menomonee Falls
State: Wisconsin
ZIP Code: 53051-3195
Phone: (414) 795-4551

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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