Individual
SAMUEL JOHN PENKALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
304 W WACKERLY ST STE 500, MIDLAND, MI 48640-7264
(989) 832-4220
(989) 832-4207
Mailing address
304 W WACKERLY ST STE 500, MIDLAND, MI 48640-7264
(989) 832-4220
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009388
MI
Other
Enumeration date
05/04/2018
Last updated
05/04/2018
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