JOSE LUIS HENAO

RAPID CITY, SD
NPI1275067613
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207RN0300X Internal Medicine, Nephrology
(Licence: NM  MD2023-1540)
Additional Taxonomies207R00000X Internal Medicine
(Licence: SD  13298)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2017-04-12
Last Update Date2024-03-15
Business Address
JOSE LUIS HENAO MD
640 FLORMANN ST
RAPID CITY, SD 57701-4679
Phone number: 605-755-3300
Mailing Address
JOSE LUIS HENAO MD
640 FLORMANN ST
RAPID CITY, SD 57701-4679
Phone number: 605-755-3300