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Individual

STEPHEN BOYD HENNINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
220 SCOTT DR, MCCOMB, MS 39648-3622
(601) 680-0371
(601) 680-0380
Mailing address
220 SCOTT DR, MCCOMB, MS 39648-3622
(601) 680-0371
(601) 680-0380

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1043
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1043
MS CHIROPRACTIC LICENSE
MS
Enumeration date
10/10/2006
Last updated
09/25/2014
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