Caleb Pennock
NPI #1720535032 in Carterville, Illinois
Provider Information
- NPI Number
- 1720535032
- Entity Type
- Individual
- Name
- Caleb Pennock
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- Sep 2, 2016
- Last Updated
- Sep 2, 2016
Practice Location
- Address
- 4474 OLD ROUTE 13
- City
- Carterville
- State
- Illinois
- ZIP Code
- 62918-3300
- Phone
- (618) 889-7076
Specialties & Taxonomy Codes
| Specialty |
|---|
| Licensed Practical Nurse |
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