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PHILLIP TROY HENNING DO

Physicians Physical Medicine & Rehabilitation Sports Medicine

Provider NPI: 1013017060

Provider Information:
 PHILLIP TROY HENNING DO
Gender: M
Not Sole Proprietor

Practice Location:
1600 E JEFFERSON ST STE 300 SEATTLE, WA 98122-5698 US
Tel: 425-498-2272  Fax: 425-498-2334

Business Mailing Address:
PO BOX 25608  SALT LAKE CITY, UT 84125-0608 US
Tel: 206-320-4476  Fax: 206-568-7043

NPI Information:
NPI: 1013017060
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N2081S0010XPhysicians
Physical Medicine & Rehabilitation
Sports Medicine
MI5101018506
N208100000XPhysicians
Physical Medicine & Rehabilitation
WAOL20000101
N208100000XPhysicians
Physical Medicine & Rehabilitation
MN103684
N208100000XPhysicians
Physical Medicine & Rehabilitation
MN51136
N208100000XPhysicians
Physical Medicine & Rehabilitation
MI5101018506
Y2081S0010XPhysicians
Physical Medicine & Rehabilitation
WAOP00002223

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 2081S0010X

Type:

Classification:



Definition:



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