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1871553933
MICHAEL HENNELLY
JEMEZ PUEBLO, NM
NPI
1871553933
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
173000000X Legal Medicine
(Licence: NM 75197)
Enumeration Date
2006-03-24
Last Update Date
2015-11-23
Business Address
-- MICHAEL HENNELLY md
110 SHEEP SPRINGS
JEMEZ PUEBLO, NM 87024-0279
Phone number: 575-834-7413
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Mailing Address
-- MICHAEL HENNELLY md
PO BOX 279
JEMEZ PUEBLO, NM 87024-0279
Phone number: 575-834-7413
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