Individual
MR. MICHAEL J HENNIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
112 ELIZABETH LN UNIT C, GENOA CITY, WI 53128-2120
(262) 279-2800
Mailing address
1350 SAINT ANDREWS RD, LAKE GENEVA, WI 53147-4944
(262) 909-0643
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2214
WI
Other
Enumeration date
05/20/2019
Last updated
05/20/2019
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