Provider Demographics
NPI:1508124603
Name:HALONE, TERRENCE KEITH
Entity Type:Individual
Prefix:MR
First Name:TERRENCE
Middle Name:KEITH
Last Name:HALONE
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 1:7308 NICOLLET AVE
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-3121
Mailing Address - Country:US
Mailing Address - Phone:612-701-7964
Mailing Address - Fax:
Practice Address - Street 1:8736 LYNDALE AVE S
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420-2738
Practice Address - Country:US
Practice Address - Phone:612-701-7964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management