Individual
ROY HENLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
7981 SUNNYSIDE RD, SAINT PAUL, MN 55112-5939
(651) 245-9401
Mailing address
7981 SUNNYSIDE RD, SAINT PAUL, MN 55112-5939
(651) 245-9401
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L 74264-3
MN
Other
Enumeration date
12/01/2014
Last updated
12/01/2014
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