Individual
MATTHEW HENNEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1540 HUMBOLDT AVE, SUITE 201, WEST ST PAUL, MN 55118-3417
(651) 457-2020
Mailing address
1540 HUMBOLDT AVE, SUITE 201, WEST ST PAUL, MN 55118-3417
(651) 457-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3467
MN
Other
Enumeration date
05/31/2016
Last updated
05/31/2016
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