Individual
DAVID AUSTIN PENGLASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BACHELORS
Contact information
Practice address
690 MORRIS ROAD APARTMENT 1, KENT, OH 44240
(978) 317-2851
Mailing address
690 MORRIS RD APT 1, KENT, OH 44240-3920
(978) 317-2851
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
S28610696
MA
Other
Enumeration date
06/12/2012
Last updated
06/12/2012
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