Hendrickson, Marilyn Marie
Hendrickson, Marilyn Marie is an sole proprietor health care provider with primary practice located at 20242 Stick Ross Mountain Rd , Tahlequah OK 74464-7374. She recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as her primary health care specialty. Hendrickson, Marilyn Marie can be contacted via phone (918) 456-1133.Contact Information
Primary practice address
20242 Stick Ross Mountain Rd
Tahlequah OK 74464-7374
Phone: (918) 456-1133
Fax: (918) 456-1133
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optician | 156FX1800X | NO LICENSE REQUIRED | Oklahoma |
Profile Details
| NPI number | 1750407391 |
|---|---|
| LBN Legal business name | Hendrickson, Marilyn Marie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 22nd, 2007 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750407391 | NPPES |
| Oklahoma | MEDICAID | 73146984401 |
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