Provider Demographics
NPI:1346624947
Name:HENNEN CHIROPRACTIC P.L.L.C.
Entity Type:Organization
Organization Name:HENNEN CHIROPRACTIC P.L.L.C.
Other - Org Name:HEALTHSOURCE OF MARSHALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:HENNEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-337-2423
Mailing Address - Street 1:1411 E COLLEGE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-2086
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:317 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-3790
Practice Address - Country:US
Practice Address - Phone:507-337-2423
Practice Address - Fax:507-337-2421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6101111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty