MEDICARE: CORY SCOTT HENNESSEY 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	10859	FL

General Provider Information

NPI Number	:	1144563826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORY SCOTT HENNESSEY DC

Provider Business Mailing Address
First Line	:	6220 N FEDERAL HWY
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-1904
Country	:	US
Telephone Number	:	954-770-1433
Fax Number	:

Provider Business Practice Location Address
First Line	:	6220 N FEDERAL HWY
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-1904
Country	:	US
Telephone Number	:	954-489-4790
Fax Number	:	954-489-9773

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

Provider Enumeration Date	:	04/01/2013
Last Update Date	:	06/08/2015

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Directions to “ CORY SCOTT HENNESSEY DC” Practice Location

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