Individual
SAMUEL PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2325 LODGE DR, GERING, NE 69341-6825
(480) 466-4659
Mailing address
2325 LODGE DR, GERING, NE 69341-6825
(480) 466-4659
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1103
NE
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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