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1174168116
JESSICA MICHELLE PENA
GEORGETOWN, TX
NPI
1174168116
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: TX 2145800)
Enumeration Date
2019-11-13
Last Update Date
2019-11-13
Business Address
JESSICA MICHELLE PENA PTA
4011 WILLIAMS DR
GEORGETOWN, TX 78628-2491
Phone number: 512-868-2700
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Mailing Address
JESSICA MICHELLE PENA PTA
9301 AXTELLON CT
AUSTIN, TX 78749-4168
Phone number: 512-743-4053
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