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Individual

MRS. AMY JOAN PECKENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1215 E MICHIGAN AVE, LANSING, MI 48912-1811
(517) 253-2436
Mailing address
8407 KINLEY RD, OVID, MI 48866-9674
(989) 307-3728

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502000855
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5502000855
MI
Enumeration date
12/26/2018
Last updated
12/26/2018
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