Individual
ROY HENTON I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3500 W SHERMAN BLVD., #305, MILWAUKEE, WI 53216
(414) 588-7180
Mailing address
PO BOX 12641, MILWAUKEE, WI 53212-0641
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
471110601
WI
Other
Enumeration date
08/18/2014
Last updated
08/18/2014
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