Individual
TEISHA PENNYWELL-KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 MILITARY ST, PORT HURON, MI 48060-5416
(810) 985-5437
(800) 248-1568
Mailing address
2610 WALNUT ST, PORT HURON, MI 48060-2851
(810) 956-2047
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
12/28/2009
Last updated
12/28/2009
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