Individual
JUSTIN SCOTT PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
136 BRISTOL EAST RD, BRISTOL, VA 24202
(276) 591-5484
(276) 591-5477
Mailing address
509 MED TECH PKWY STE 100, JOHNSON CITY, TN 37604-2579
(423) 952-2111
(423) 952-2175
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305212215
VA
2255A2300X
Athletic Trainer
0126002702
VA
Other
Enumeration date
08/22/2018
Last updated
08/23/2018
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