Provider Demographics
NPI:1194787788
Name:HENSLEY, BRIEANNE M (ATC)
Entity type:Individual
Prefix:
First Name:BRIEANNE
Middle Name:M
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 BROOKDALE ST
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-2018
Mailing Address - Country:US
Mailing Address - Phone:517-285-6473
Mailing Address - Fax:
Practice Address - Street 1:2282 SPRINGPORT RD
Practice Address - Street 2:SUITE F
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-1460
Practice Address - Country:US
Practice Address - Phone:517-841-7497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer