Individual
MS. PENNY S LONGTHORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
9664A WINTER GARDENS BLVD, LAKESIDE, CA 92040-3909
(619) 390-3766
Mailing address
9664A WINTER GARDENS BLVD, LAKESIDE, CA 92040-3909
(619) 390-3766
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4848
CA
Other
Enumeration date
04/08/2010
Last updated
04/08/2010
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