Provider Demographics
NPI:1891737409
Name:HENNEN HEALTH SYSTEM
Entity Type:Organization
Organization Name:HENNEN HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:ROGER
Authorized Official - Last Name:HENNEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:719-380-0138
Mailing Address - Street 1:3510 GALLEY RD
Mailing Address - Street 2:STE 104
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-4312
Mailing Address - Country:US
Mailing Address - Phone:719-380-0138
Mailing Address - Fax:
Practice Address - Street 1:3510 GALLEY RD
Practice Address - Street 2:STE 104
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-4312
Practice Address - Country:US
Practice Address - Phone:719-380-0138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2926111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty