Provider Demographics
NPI:1871797043
Name:DAVID M HENSLEY D.C., P.C.
Entity type:Organization
Organization Name:DAVID M HENSLEY D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-787-4221
Mailing Address - Street 1:1866 S ARGUS CT
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-5104
Mailing Address - Country:US
Mailing Address - Phone:517-787-4221
Mailing Address - Fax:517-787-6943
Practice Address - Street 1:3305 SPRING ARBOR RD
Practice Address - Street 2:SUITE 800
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3794
Practice Address - Country:US
Practice Address - Phone:517-787-4221
Practice Address - Fax:517-787-6943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950C85005OtherBLUE CROSS BLUE SHIELD
MIT32927Medicare UPIN
MI0C85005Medicare ID - Type Unspecified