Individual
BRENDA LEE HENTGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
407 5TH ST NW, MONTGOMERY, MN 56069-1026
(612) 203-4779
Mailing address
407 5TH ST NW, MONTGOMERY, MN 56069-1026
(612) 203-4779
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L558769
MN
Other
Enumeration date
03/13/2015
Last updated
03/13/2015
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