Provider Demographics
NPI:1740209386
Name:HENRY, MICHELE (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:HENRY
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 1:257 FAULK RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-5346
Mailing Address - Country:US
Mailing Address - Phone:757-625-4458
Mailing Address - Fax:757-627-2499
Practice Address - Street 1:740 DUKE ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1515
Practice Address - Country:US
Practice Address - Phone:757-625-4458
Practice Address - Fax:757-627-2499
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104002077111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor