| Doctor Name: | MARK W HENEBRY |
| NPI Number: | 1497993174 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T. |
| License Number: | 2009002205 |
| Business Practice Address: | 108 Professional Parkway Dr. Troy, MO - 633792823 |
| Business Phone Number: | 6365286080 |
| Business Fax Number: | 6365283973 |
| Mailing Address: | 108 Professional Parkway Dr., TROY |
| State: | MO |
| Postal Code: | 633792823 |
| Phone Number: | 6365286080 |
| Fax Number: | 6365283973 |
| NPI Enumeration Date: | 02/03/2009 |
| NPI Last Update Date: | 04/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2009002205 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |