Individual
MR. JAMES THOMAS PENKALSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
901 S NATIONAL AVE, FORSYTHE ATHLETIC CENTER, RM 109, SPRINGFIELD, MO 65804-0027
(417) 836-5461
(417) 836-6101
Mailing address
901 S NATIONAL AVE, FORSYTHE ATHLETIC CENTER, RM 109, SPRINGFIELD, MO 65804-0027
(417) 836-5461
(417) 836-6101
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
00159
MO
Other
Enumeration date
08/17/2005
Last updated
03/23/2010
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