Individual
LENA NENNINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
12 PROSPECT ST EXT, TERRYVILLE, CT 06786
(860) 796-4287
Mailing address
12 PROSPECT STREET EXT, TERRYVILLE, CT 06786-5410
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000959
CT
Other
Enumeration date
12/07/2012
Last updated
03/27/2015
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