Individual
MRS. BRANDI L PENATZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
337 SOMERSET ST, JOHNSTOWN, PA 15901
(814) 534-4724
Mailing address
337 SOMERSET ST, JOHNSTOWN, PA 15901-2541
(814) 534-4724
(412) 235-4012
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MA-052554
PA
207X00000X
Orthopaedic Surgery Physician
MA052554
PA
363A00000X
Physician Assistant
Primary
MA052554
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA-052554
LICENSE #
PA
Enumeration date
02/08/2007
Last updated
06/18/2018
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