Provider Demographics
NPI:1891073615
Name:HENRY, STEPHEN CRAIG II (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:CRAIG
Last Name:HENRY
Suffix:II
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 1:4664 GOLDEN APPLES TRL
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-5201
Mailing Address - Country:US
Mailing Address - Phone:850-865-4221
Mailing Address - Fax:
Practice Address - Street 1:821 DEBARY AVE
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-8805
Practice Address - Country:US
Practice Address - Phone:386-860-5448
Practice Address - Fax:386-668-3665
Is Sole Proprietor?:No
Enumeration Date:2011-07-27
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10373111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor