Individual
KELLY PENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1289 M 89, PLAINWELL, MI 49080-1955
(269) 685-2307
Mailing address
519 WOODS RD, BATTLE CREEK, MI 49015-3732
(269) 986-3397
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502004215
MI
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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