Provider Demographics
NPI:1356482897
Name:HENDRIX, MICHAEL DAVID (CNMT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:DAVID
Last Name:HENDRIX
Suffix:
Gender:M
Credentials:CNMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 CHURCH ST STE 109
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-3330
Mailing Address - Country:US
Mailing Address - Phone:404-377-9854
Mailing Address - Fax:
Practice Address - Street 1:215 CHURCH ST STE 109
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3330
Practice Address - Country:US
Practice Address - Phone:404-377-9854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist