Provider Demographics
NPI:1386662120
Name:HENZE, DAVID P (ATC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:P
Last Name:HENZE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3435 HEATHER LN
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35216-4401
Mailing Address - Country:US
Mailing Address - Phone:205-979-8408
Mailing Address - Fax:205-975-7286
Practice Address - Street 1:210E BARTOW ARENA
Practice Address - Street 2:617 13TH ST SO
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0001
Practice Address - Country:US
Practice Address - Phone:205-934-9040
Practice Address - Fax:205-975-7286
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0472255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer