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General NPI Number Information
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NPI Number | 1497575419
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Entity Type | Organization
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Legal Business Name | HENDERSON CHIROPRACTIC, P. A.
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 220 13TH ST S
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City | BENSON
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State | MN
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Zip | 56215-1858
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Country | US
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Telephone | 320-314-2368
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Fax |
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Provider Business Mailing Address
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Address Line | 220 13TH ST S
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City | BENSON
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State | MN
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Zip | 56215-1858
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Country | US
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Telephone | 320-314-2368
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | JOSHUA LYLE HENDERSON
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Credential | D.C.
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Telephone | 320-314-2368
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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 |
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License Number State |
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