Individual
KELLY BROOK PENNINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
721 W MULBERRY ST, ANGLETON, TX 77515-4239
(979) 849-8281
Mailing address
3150 BOBBER ST, FRISCO, TX 75034-4267
(361) 571-4946
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2140159
TX
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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