Provider Demographics
NPI:1225453285
Name:HENRION, GUY
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:
Last Name:HENRION
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 W KENOSHA ST
Mailing Address - Street 2:#210
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-8952
Mailing Address - Country:US
Mailing Address - Phone:785-829-0352
Mailing Address - Fax:918-893-5694
Practice Address - Street 1:2608 W KENOSHA ST
Practice Address - Street 2:#210
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-8952
Practice Address - Country:US
Practice Address - Phone:785-829-0352
Practice Address - Fax:918-893-5694
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK661KQC343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)