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Organization
HENRY CHIROPRACTIC CLINIC PLLC
Active
Organization
HENRY CHIROPRACTIC CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN K HENRY D.C. (OWNER DOCTOR)
(662) 890-5454
Entity
Organization
Contact information
Practice address
8820 GOODMAN RD, OLIVE BRANCH, MS 38654-2204
(662) 890-5454
(662) 893-8343
Mailing address
8820 GOODMAN RD, OLIVE BRANCH, MS 38654-2204
(662) 890-5454
(662) 893-8343
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
965
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174676647
NPI
MS
01
—
1346239290
DR. BRIAN K HENRY NPI
—
01
—
4140696
BLUE CROSS BLUE SHIELD
TN
01
—
428516988B
BLUE CROSS BLUE SHIELD
MS
01
—
4430072
UNITED HEALTHCARE
MS
01
—
4433003
UNITED HEALTHCARE
TN
01
—
512G700109
MEDICARE GRP PTAN
MS
01
—
5455686
AETNA
—
01
—
6241720001
CIGNA MEDICARE DME
—
01
—
6332775
CIGNA
—
Enumeration date
01/19/2007
Last updated
10/21/2015
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