Individual
JENNY PETRENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
111 WELLMORE DR, TEGA CAY, SC 29708-0124
(803) 836-7026
Mailing address
111 WELLMORE DR, TEGA CAY, SC 29708-0124
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3526
SC
225200000X
Physical Therapy Assistant
A5776
NC
Other
Enumeration date
04/05/2016
Last updated
08/09/2016
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