THEA C PENNYWELL

SHREVEPORT, LA
NPI1295038149
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: LA  PA200405)
Enumeration Date2010-12-15
Last Update Date2010-12-15
Business Address
-- THEA C PENNYWELL PA
7925 YOUREE DR SUITE 220
SHREVEPORT, LA 71105-5127
Phone number: 318-424-3400
Mailing Address
-- THEA C PENNYWELL PA
7925 YOUREE DR SUITE 220
SHREVEPORT, LA 71105-5127
Phone number: 318-424-3400
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