Individual
PENELOPE DIANE COCKREL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4102 MINNICH AVE, PADUCAH, KY 42001-4642
(270) 556-8886
Mailing address
4102 MINNICH AVE, PADUCAH, KY 42001-4642
(270) 556-8886
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001875
KY
Other
Enumeration date
01/27/2017
Last updated
01/27/2017
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