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Individual

KATHLEEN PENNOCK

Active
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Individual

KATHLEEN PENNOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, PT

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305202695
VA
2251X0800X
Orthopedic Physical Therapist
2305202695

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010206626
VA
01
192289
ANTHEM HANOVER PT
VA
01
258462
SOUTHERN HEALTH
VA
01
540885859
PRIVATE HEALTHCARE SYSTEM
VA
01
98999
OPTIMA HEALTH
VA
Enumeration date
06/04/2006
Last updated
01/09/2025
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