Individual
JOHN PENLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AT
Contact information
Practice address
1630 BOGIE LAKE RD, WHITE LAKE, MI 48383
(734) 474-0783
Mailing address
PO BOX 1356, BRIGHTON, MI 48116
(734) 474-0783
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
2601001645
MI
Other
Enumeration date
01/04/2017
Last updated
01/04/2017
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