Individual
MRS. JORDYN E PENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2502 S ASHLAND AVE, ASHWAUBENON, WI 54304-5252
(920) 496-4700
Mailing address
2521 45TH ST, TWO RIVERS, WI 54241-1131
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14217-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100077342
—
WI
Enumeration date
05/16/2018
Last updated
12/19/2024
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