Individual
PENNEY MUSKOPF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
14825 N OUTER 40, SUITE 200, CHESTERFIELD, MO 63017-2152
(314) 336-2555
Mailing address
104 LIEDERKRANZ LN, MILLSTADT, IL 62260-2266
(618) 476-9015
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
06-175
MO
Other
Enumeration date
05/11/2007
Last updated
07/08/2007
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