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General NPI Number Information
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NPI Number | 1578104030
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Entity Type | Organization
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Legal Business Name | HENRY WELLNESS CENTER
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Dates
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Enumeration Date | 10/04/2019
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Last Update Date | 10/04/2019
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Provider Practice Location Address
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Address Line | 2879 E POINT ST STE 11
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City | EAST POINT
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State | GA
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Zip | 30344-3301
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Country | US
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Telephone | 404-518-6825
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Fax | 404-506-9157
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Provider Business Mailing Address
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Address Line | 2879 E POINT ST STE 11
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City | EAST POINT
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State | GA
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Zip | 30344-3301
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Country | US
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Telephone | 404-518-6825
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Fax | 404-506-9157
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Authorized Official
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Title or Position | OWNER
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Name | DR. JASON ALAN HENRY
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Credential | DC
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Telephone | 404-731-9921
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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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