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Individual

MATTHEW M PENNUCCI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
4251 LAHMEYER RD, FORT WAYNE, IN 46815-5676
(260) 482-7800
Mailing address
4251 LAHMEYER RD, FORT WAYNE, IN 46815-5676

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05012923A
IN

Other

Enumeration date
06/11/2018
Last updated
06/11/2018
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