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Individual

CHAD MICHAEL PENS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
37 W GARDEN ST, SUITE 103, AUBURN, NY 13021-2662
(315) 253-3291
(315) 258-8759
Mailing address
37 W GARDEN ST, SUITE 103, AUBURN, NY 13021-2662
(315) 253-3291
(315) 258-8759

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
022423
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02510016
NY
Enumeration date
10/12/2005
Last updated
07/08/2007
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