Individual
PAMELA MARY PENNYCOOKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
105 HILLTOP TRL E, FORT ATKINSON, WI 53538-2605
(920) 691-6595
Mailing address
105 HILLTOP TRL E, FORT ATKINSON, WI 53538-2605
(920) 691-6595
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
WI
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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