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General NPI Number Information
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NPI Number | 1407151293
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Entity Type | Individual
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Provider Name | DAVID ALAN HENNING DC
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Gender | Male
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Dates
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Enumeration Date | 01/25/2011
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Last Update Date | 05/24/2016
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Provider Practice Location Address
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Address Line | 1557 COON RAPIDS BLVD NW
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City | COON RAPIDS
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State | MN
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Zip | 55433-4799
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Country | US
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Telephone | 763-767-7499
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Fax | 763-767-7517
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Provider Business Mailing Address
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Address Line | 1573 154TH AVE NW STE 102
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City | ANDOVER
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State | MN
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Zip | 55304-2696
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Country | US
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Telephone | 763-413-0032
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Fax | 763-432-3688
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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 | 5457
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License Number State | MN
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