Individual
COLLEEN MARIE PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST/CSFA
Contact information
Practice address
87936 LIMPIT LN, FLORENCE, OR 97439-9053
(541) 997-8414
Mailing address
87936 LIMPIT LN, FLORENCE, OR 97439-9053
(541) 999-7813
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
190198
—
Other
Enumeration date
12/11/2019
Last updated
12/11/2019
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