Provider Demographics
NPI:1598031361
Name:HENDERSON, ADAM JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:JOSEPH
Last Name:HENDERSON
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 1:103 SUM MOR DR
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-4828
Mailing Address - Country:US
Mailing Address - Phone:803-244-9212
Mailing Address - Fax:
Practice Address - Street 1:103 SUM MOR DR
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4828
Practice Address - Country:US
Practice Address - Phone:803-244-9212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3696111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor