Provider Demographics
NPI:1407806839
Name:HENDERSON, SHEILA (DC)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:HENDERSON
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 1:413 FARRS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29617-1858
Mailing Address - Country:US
Mailing Address - Phone:864-246-0803
Mailing Address - Fax:864-246-0555
Practice Address - Street 1:413 FARRS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29617-1858
Practice Address - Country:US
Practice Address - Phone:864-246-0803
Practice Address - Fax:864-246-0555
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1719111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor