MR. Larry Paul Penwright JR., HIS

NPI #1609909142 in Ada, Oklahoma

Provider Information

NPI Number: 1609909142
Entity Type: Individual
Name: MR. Larry Paul Penwright JR., HIS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: HIS
Enumeration Date: Mar 13, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 703 N BROADWAY AVE
Address 2: SUITE 2
City: Ada
State: Oklahoma
ZIP Code: 74820-3457
Phone: (580) 436-3277

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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