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Individual
DR. TIMOTHY JAMES HENDERSON
Active
Individual
DR. TIMOTHY JAMES HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1055
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13959
AVERA
SD
01
—
249390
MIDLANDS CHOICE
SD
01
—
48322
SIOUX VALLEY HEALTH PLAN
SD
01
—
4994541
WELLMARK
SD
05
—
7602530
—
SD
Enumeration date
05/05/2006
Last updated
03/31/2015
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