Provider Demographics
NPI:1285817908
Name:MCHENRY, NIKKI (DC)
Entity Type:Individual
Prefix:DR
First Name:NIKKI
Middle Name:
Last Name:MCHENRY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 MULKEY RD STE 9B
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1122
Mailing Address - Country:US
Mailing Address - Phone:770-996-6400
Mailing Address - Fax:770-996-5999
Practice Address - Street 1:1790 MULKEY RD STE 9B
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1122
Practice Address - Country:US
Practice Address - Phone:770-996-6400
Practice Address - Fax:770-996-5999
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008145111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor