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1255696910
JODY LYNN PENNYCOOK
SANTA ROSA, CA
NPI
1255696910
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant Medical
(Licence: CA PA22225)
Enumeration Date
2012-07-09
Last Update Date
2012-07-09
Business Address
MISS JODY LYNN PENNYCOOK PA
4740 HOEN AVE
SANTA ROSA, CA 95405-7824
Phone number: 707-542-2783
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Mailing Address
MISS JODY LYNN PENNYCOOK PA
4740 HOEN AVE
SANTA ROSA, CA 95405-7824
Phone number: 707-542-2783
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