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Individual

MACEY PENNINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1001 HOSPITAL RD, STARKVILLE, MS 39759-2125
(662) 323-6360
Mailing address
1001 HOSPITAL RD, STARKVILLE, MS 39759-2125

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3774
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
80734522
EMPLOYER
Enumeration date
02/28/2022
Last updated
02/28/2022
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