Individual
MRS. NANCY PEVNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
845 N NEW BALLAS CT, SUITE 40, SAINT LOUIS, MO 63141-7134
(314) 872-1644
(314) 872-1801
Mailing address
845 N NEW BALLAS CT, SUITE 40, SAINT LOUIS, MO 63141-7134
(314) 872-1644
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2002024765
MO
Other
Enumeration date
11/02/2007
Last updated
11/02/2007
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