Stacey L Penvose, ATC
NPI #1912184425 in Millersburg, Pennsylvania
Provider Information
- NPI Number
- 1912184425
- Entity Type
- Individual
- Name
- Stacey L Penvose, ATC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC
- Enumeration Date
- Jan 28, 2008
- Last Updated
- Jan 28, 2008
Practice Location
- Address
- 75 EVELYN DR
- City
- Millersburg
- State
- Pennsylvania
- ZIP Code
- 17061-1258
- Phone
- (717) 692-4708
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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