Provider Demographics
NPI:1831170554
Name:HENDRIX, PATSY CLAUDIA (TECHNICIAN)
Entity type:Individual
Prefix:MISS
First Name:PATSY
Middle Name:CLAUDIA
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:PATSY HENDRIX 191 TERRI ROAD
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240
Mailing Address - Country:US
Mailing Address - Phone:706-882-1411
Mailing Address - Fax:706-845-3700
Practice Address - Street 1:1514 VERNON RD
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240-4131
Practice Address - Country:US
Practice Address - Phone:706-882-1411
Practice Address - Fax:706-845-3700
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA246ZEO500X246ZE0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG