Individual
TRISTAN PENNELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
675 WATER ST, EXCELSIOR, MN 55331-3158
(952) 906-7855
Mailing address
675 WATER ST, EXCELSIOR, MN 55331-3158
(952) 906-7855
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
73409
MN
Other
Enumeration date
04/28/2021
Last updated
01/06/2025
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