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Individual

PAUL J HENNICKEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
1624 WOODRUFF RD STE 8, GREENVILLE, SC 29607-5944
(864) 363-5239
Mailing address
68 GLOBAL DR, SUITE 100, GREENVILLE, SC 29607-4628
(864) 644-2700
(864) 644-2709

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3322
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3322
DC LICENSE
SC
Enumeration date
03/03/2008
Last updated
11/10/2010
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