Provider Demographics
NPI:1316561020
Name:HENRIE CHIROPRACTIC PC
Entity Type:Organization
Organization Name:HENRIE CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HENRIE
Authorized Official - Suffix:SR
Authorized Official - Credentials:DC
Authorized Official - Phone:619-354-0925
Mailing Address - Street 1:1333 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-3434
Mailing Address - Country:US
Mailing Address - Phone:619-444-4792
Mailing Address - Fax:619-444-4892
Practice Address - Street 1:1333 N 2ND ST
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-3434
Practice Address - Country:US
Practice Address - Phone:619-444-4792
Practice Address - Fax:619-444-4892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1063841609OtherNPPES