Individual
SAMANTHA PENNEPACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2004 SPROUL RD, BROOMALL, PA 19008-3511
(610) 359-1580
Mailing address
PO BOX 34990, BELFAST, ME 04915-0627
(610) 359-5672
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA058738
PA
Other
Enumeration date
11/16/2016
Last updated
06/04/2024
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