MEDICARE: HENARD FAMILY CHIROPRACTIC, INC.

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225282155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HENARD FAMILY CHIROPRACTIC, INC.

Provider Business Mailing Address
First Line	:	4566 E HIGHWAY 20 STE 205
Second Line	:
City	:	NICEVILLE
State	:	FL
Zip	:	32578-8839
Country	:	US
Telephone Number	:	850-897-1105
Fax Number	:	850-897-1108

Provider Business Practice Location Address
First Line	:	4566 E HIGHWAY 20 STE 205
Second Line	:
City	:	NICEVILLE
State	:	FL
Zip	:	32578-8839
Country	:	US
Telephone Number	:	850-897-1105
Fax Number	:	850-897-1108

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KAREN HENARD BENHAMRON
Credential	:	D.C.
Telephone Number	:	850-897-1105

Provider Enumeration Date	:	11/05/2008
Last Update Date	:	02/12/2009

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