Provider First Line Business Practice Location Address:
412 MOUNTAIN DRIVE
Provider Second Line Business Practice Location Address:
DR STEPHEN C HENRY HENRY CHIROPRACTIC CLINIC
Provider Business Practice Location Address City Name:
DESTIN
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32541-2334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-837-2838
Provider Business Practice Location Address Fax Number:
850-837-7768
Provider Enumeration Date:
11/07/2006