Individual
MR. JASON LOUIS PENNELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
251 CANAAN RD, SALISBURY, CT 06068-1602
(315) 323-4566
Mailing address
251 CANAAN RD, SALISBURY, CT 06068-1602
(315) 323-4566
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001070
CT
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
02/09/2021
Last updated
02/09/2021
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