Individual
MRS. BEVERLY JAMISON PENNICOOKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
330 GOLDEN SHORE DR, LONG BEACH, CA 90802
(562) 256-7550
Mailing address
3503 LINDEN AVE APT 201, LONG BEACH, CA 90807-4532
(562) 400-8618
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT3766
CA
Other
Enumeration date
12/04/2015
Last updated
12/04/2015
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