Individual
STEPHEN LEE PENICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
1018 W MAIN ST, LEBANON, TN 37087-3302
(615) 466-5200
(615) 466-5206
Mailing address
1018 W MAIN ST, LEBANON, TN 37087-3302
(615) 466-5200
(615) 466-5206
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 425
TN
Other
Enumeration date
04/05/2010
Last updated
04/05/2010
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