Individual
MR. JACK PENAFIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTAL
Contact information
Practice address
7960 SCOTT LEVEL, BALTIMORE, MD 21208
(410) 521-3600
Mailing address
9860 BALE CT, OWINGS MILLS, MD 21117-6386
(443) 827-0876
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
A00483
MD
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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