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Individual

DR. BRIAN KEITH HENRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

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
3149677
B/C B/S OF TN
TN
01
4430072
UNITED HEALTHCARE
MS
01
4433003
UNITED HEALTHCARE
TN
01
5455686
AETNA
MS
01
6241720001
CIGNA GOVERNMENT SERVICES
01
6332775
CIGNA
MS
Enumeration date
10/13/2005
Last updated
01/05/2011
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