Individual
TANNYA I PENNINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
154 CORNERSTONE BLVD, HOT SPRINGS, AR 71913-6560
(501) 525-0575
Mailing address
PO BOX 183, LONOKE, AR 72086-0183
(501) 425-9738
(501) 676-3386
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1343
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140877721
—
AR
Enumeration date
02/22/2018
Last updated
06/16/2018
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