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NPI 1134122013

NPI 1134122013 : TIMOTHY J HENRY D.C. : DAYTON, TN

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General NPI Number Information
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    NPI Number           |    1134122013
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    Entity Type          |    Individual 
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    Provider Name        |    TIMOTHY J HENRY D.C.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/24/2005
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    Last Update Date     |    09/27/2016
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Provider Practice Location Address
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    Address Line         |    7274 RHEA COUNTY HWY 
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    City                 |    DAYTON
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    State                |    TN
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    Zip                  |    37321-6205
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    Country              |    US
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    Telephone            |    423-775-0192
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    Fax                  |    423-775-5538
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Provider Business Mailing Address
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    Address Line         |    7274 RHEA COUNTY HWY 
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    City                 |    DAYTON
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    State                |    TN
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    Zip                  |    37321-6205
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    Country              |    US
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    Telephone            |    423-775-0192
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    Fax                  |    423-775-5538
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    DC0000000448
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    License Number State |    TN
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