Individual
JOHN HENNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
123 CANOSIA RD, ESKO, MN 55733-9530
(218) 590-0132
Mailing address
PO BOX 321, ESKO, MN 55733-0321
(218) 590-0132
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1880889
MN
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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