Individual
MS. TRACEY O PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.,M.P.H.
Contact information
Practice address
5320 PROVIDENCE RD, SUITE 204, VIRGINIA BEACH, VA 23464-4122
(757) 962-2121
(757) 962-1911
Mailing address
5320 PROVIDENCE RD, SUITE 204, VIRGINIA BEACH, VA 23464-4122
(757) 962-2121
(757) 962-1911
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
0101231849
VA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
0101231849
VA
Other
Enumeration date
06/22/2006
Last updated
02/03/2016
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