Provider Demographics
NPI:1952162430
Name:HENRY, JOSEPH D
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:D
Last Name:HENRY
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 1:805 SUNNYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-3164
Mailing Address - Country:US
Mailing Address - Phone:419-631-4264
Mailing Address - Fax:
Practice Address - Street 1:805 SUNNYSIDE DR
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-3164
Practice Address - Country:US
Practice Address - Phone:419-631-4264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel