Individual
MR. SANDY JAY PENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
429 WEST ELM STREET., HOBART, OK 73651
(580) 726-3324
Mailing address
429 WEST ELM STREET., HOBART, OK 73651
(580) 726-3324
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0049080
OK
Other
Enumeration date
09/25/2006
Last updated
07/08/2007
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