Individual
MARTHA PENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2576 LAWRENCEVILLE SUWANEE RD, SUWANEE, GA 30024-7290
(770) 962-4043
Mailing address
2997 NORTHBROOK DR, DORAVILLE, GA 30340-4321
(404) 375-2836
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA004810
GA
Other
Enumeration date
03/23/2022
Last updated
03/23/2022
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