Provider Demographics
NPI:1508116898
Name:HENEY CHIROPRACTIC NEUROLOGY CENTER, LLC
Entity Type:Organization
Organization Name:HENEY CHIROPRACTIC NEUROLOGY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:HENEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:781-826-8500
Mailing Address - Street 1:46 COLUMBIA ROAD
Mailing Address - Street 2:8
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-1862
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:46 COLUMBIA ROAD
Practice Address - Street 2:8
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1862
Practice Address - Country:US
Practice Address - Phone:781-826-8500
Practice Address - Fax:781-826-8585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1706261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAU32589Medicare UPIN
MAY36200Medicare PIN