Provider Demographics
NPI:1902800337
Name:HENEY, JOHN JOSEPH (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:JOSEPH
Last Name:HENEY
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 1:24 ROCKLAND ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-2226
Mailing Address - Country:US
Mailing Address - Phone:781-826-7397
Mailing Address - Fax:781-826-7469
Practice Address - Street 1:24 ROCKLAND ST
Practice Address - Street 2:UNIT 1
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-2226
Practice Address - Country:US
Practice Address - Phone:781-826-7397
Practice Address - Fax:781-826-7469
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA869111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAT58285Medicare UPIN
MAY35606Medicare ID - Type Unspecified