Individual
JERRY L HENNEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1540 S 108TH ST, WEST ALLIS, WI 53214-4019
(414) 453-5806
(414) 453-5052
Mailing address
4200 S CHURCH DR, NEW BERLIN, WI 53151-5612
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10622-40
WI
Other
Enumeration date
04/07/2012
Last updated
10/26/2016
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