Individual
JENNIFER PENDERGRASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2800 S FORT AVE, SPRINGFIELD, MO 65807-3480
(417) 882-0035
Mailing address
2800 S FORT AVE, SPRINGFIELD, MO 65807-3480
(417) 882-0035
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2014024570
MO
Other
Enumeration date
10/28/2016
Last updated
10/28/2016
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