Individual
PENELOPE JAYNE FOVALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.AC., L.AC.
Contact information
Practice address
8720 GEORGIA AVE STE 300, SILVER SPRING, MD 20910-3614
(301) 565-4924
Mailing address
8606 GRANT ST, BETHESDA, MD 20817-3754
(240) 423-9592
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
U02671
MD
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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