Individual
JAASHA PENA GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, WCS
Contact information
Practice address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(910) 449-1586
Mailing address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251X0800X
Orthopedic Physical Therapist
30293
AZ
Other
Enumeration date
09/12/2018
Last updated
08/23/2024
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