Provider Demographics
NPI:1568540151
Name:HENNAGIR, JULIA (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:HENNAGIR
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:PO BOX 1350
Mailing Address - Street 2:
Mailing Address - City:CORTARO
Mailing Address - State:AZ
Mailing Address - Zip Code:85652-1350
Mailing Address - Country:US
Mailing Address - Phone:520-906-6902
Mailing Address - Fax:520-682-4580
Practice Address - Street 1:9775 N CLAYTON RD
Practice Address - Street 2:
Practice Address - City:MARANA
Practice Address - State:AZ
Practice Address - Zip Code:85653-9266
Practice Address - Country:US
Practice Address - Phone:520-906-6902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5923111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0423590OtherBLUE CROSS/BLUE SHIELD
AZAZ0423590OtherBLUE CROSS/BLUE SHIELD