ROY RANDEL HENNEBERG

COEUR D ALENE, ID
NPI1114956216
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy174400000X Specialist
(Licence: ID  M4722)
Enumeration Date2006-07-01
Last Update Date2020-05-14
Business Address
ROY RANDEL HENNEBERG MD
980 W IRONWOOD DR SUITE 304
COEUR D ALENE, ID 83814
Phone number: 208-765-4888
Mailing Address
ROY RANDEL HENNEBERG MD
980 W IRONWOOD DR STE 201
COEUR D ALENE, ID 83814-2668
Phone number: 208-765-4888
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