Provider Demographics
NPI:1710917570
Name:DEGRAAF, HENK F (DC)
Entity Type:Individual
Prefix:
First Name:HENK
Middle Name:F
Last Name:DEGRAAF
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 1:1446 HAMMOND POND RD
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-2039
Mailing Address - Country:US
Mailing Address - Phone:803-279-7721
Mailing Address - Fax:803-279-7721
Practice Address - Street 1:647 MAIN ST
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-7456
Practice Address - Country:US
Practice Address - Phone:706-986-9620
Practice Address - Fax:706-986-9620
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA4976111N00000X
SC1603111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCDMMMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
GAU34287Medicare UPIN