Provider Demographics
NPI:1407151293
Name:HENNING, DAVID ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALAN
Last Name:HENNING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1573 154TH AVE NW
Mailing Address - Street 2:STE 102
Mailing Address - City:ANDOVER
Mailing Address - State:MN
Mailing Address - Zip Code:55304-2696
Mailing Address - Country:US
Mailing Address - Phone:763-413-0032
Mailing Address - Fax:763-432-3688
Practice Address - Street 1:1557 COON RAPIDS BLVD NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-4799
Practice Address - Country:US
Practice Address - Phone:763-767-7499
Practice Address - Fax:763-767-7517
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5457111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor