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Individual

ANGELA MICHELLE PENTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
109 SPRUCE ST, GREENEVILLE, TN 37745-3921
(423) 620-4439
Mailing address
109 SPRUCE ST, GREENEVILLE, TN 37745-3921
(423) 620-4439

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2085893
TX
225200000X
Physical Therapy Assistant
4312
TN

Other

Enumeration date
11/02/2011
Last updated
11/02/2011
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