MEDICARE: DR. DENNIS WAYNE HENSON DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	006272	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508852450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS WAYNE HENSON DC

Provider Business Mailing Address
First Line	:	1601 E 9TH ST
Second Line	:	SUITE C
City	:	TRENTON
State	:	MO
Zip	:	64683-2763
Country	:	US
Telephone Number	:	660-359-5900
Fax Number	:	660-359-5901

Provider Business Practice Location Address
First Line	:	1601 E 9TH ST
Second Line	:	SUITE C
City	:	TRENTON
State	:	MO
Zip	:	64683-2763
Country	:	US
Telephone Number	:	660-359-5900
Fax Number	:	660-359-5901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	10/03/2014

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