Individual
DR. TRACI SUSANNE PENNOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
6730 ROOSEVELT AVE STE 205, MIDDLETOWN, OH 45005-5743
(513) 597-0605
Mailing address
6730 ROOSEVELT AVE STE 205, MIDDLETOWN, OH 45005-5743
(513) 597-0605
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3471
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2852720
—
OH
Enumeration date
02/27/2008
Last updated
08/29/2023
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