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Individual

MR. TARAS MYCHAJLO PENKALSKYJ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MT

Contact information

Practice address
8400 BUSTLETON AVE, SUITE 9, PHILA, PA 19152-1918
(215) 725-2300
Mailing address
8400 BUSTLETON AVE, SUITE 9, PHILA, PA 19152-1918
(215) 725-2300

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG001563
PA

Other

Enumeration date
01/20/2012
Last updated
01/20/2012
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