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Individual

DR. WALTER E. HENDERSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1101 FARMINGTON AVE, BERLIN, CT 06037-2241
(860) 828-8220
(860) 828-8232
Mailing address
1097 FARMINGTON AVE, BERLIN, CT 06037-2241
(860) 828-8220
(860) 828-8232

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
001443
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050001443CT01
BLUE CROSS BLUE SHIELD
CT
01
47-0862263
CIGNA
CT
01
P2811446
OXFORD HEALTH
CT
Enumeration date
01/10/2007
Last updated
09/20/2016
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