Individual
AMY JO PENNAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
11 BRIDGE STREET PLAZA, ELKTON, MD 21921
(410) 392-0800
Mailing address
1600 UNIVERSITY AVE, STE 10A, SAINT PAUL, MN 55104-3828
(651) 646-7246
(651) 641-0726
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J1-0002377
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326290818
—
DE
01
—
3579964000
IBC AMERIHEALTH
—
Enumeration date
10/16/2008
Last updated
07/10/2015
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