Individual
DR. TIMOTHY JAMES HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
610 EAST BLVD, RAPID CITY, SD 57701-2902
(605) 342-3908
(605) 342-0250
Mailing address
610 EAST BLVD, RAPID CITY, SD 57701-2902
(605) 342-3908
(605) 342-0250
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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