Provider Demographics
NPI:1679878656
Name:HENNINGS, MICHAEL JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JAMES
Last Name:HENNINGS
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 1:3662 SW 30TH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-3720
Mailing Address - Country:US
Mailing Address - Phone:772-220-5880
Mailing Address - Fax:772-220-5888
Practice Address - Street 1:3662 SW 30TH AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-3720
Practice Address - Country:US
Practice Address - Phone:772-220-5880
Practice Address - Fax:772-220-5888
Is Sole Proprietor?:No
Enumeration Date:2011-01-21
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10214111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology