Provider Demographics
NPI:1932429958
Name:HENSLEY, KIMLEY CRAIG JR (DC)
Entity type:Individual
Prefix:DR
First Name:KIMLEY
Middle Name:CRAIG
Last Name:HENSLEY
Suffix:JR
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 1:900 OLD WINSTON RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-9964
Mailing Address - Country:US
Mailing Address - Phone:336-904-0752
Mailing Address - Fax:
Practice Address - Street 1:900 OLD WINSTON RD
Practice Address - Street 2:SUITE 208
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-9964
Practice Address - Country:US
Practice Address - Phone:336-904-0752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4085111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor