Individual
ANNISA SUZETTE PENFOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5006 COPPER AVE NE, ALBUQUERQUE, NM 87108-1301
(505) 268-7988
Mailing address
9468 E COLONIAL DR, ORLANDO, FL 32817-4150
(407) 281-3803
(407) 249-8916
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA26785
FL
Other
Enumeration date
01/24/2017
Last updated
02/05/2024
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