Provider Demographics
NPI:1285722793
Name:HENRY, DARNITA (DC)
Entity type:Individual
Prefix:DR
First Name:DARNITA
Middle Name:
Last Name:HENRY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2912 CAMBRIDGE DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-5418
Mailing Address - Country:US
Mailing Address - Phone:678-478-2219
Mailing Address - Fax:404-349-1930
Practice Address - Street 1:3480 GREENBRIAR PKWY SW
Practice Address - Street 2:SUITE 206 D
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-3126
Practice Address - Country:US
Practice Address - Phone:678-478-2219
Practice Address - Fax:404-349-1930
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO007951111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1065559OtherASH