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1356923361
TRISTAN PENNELLA
MANKATO, MN
NPI
1356923361
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-04-28
Last Update Date
2021-05-21
Business Address
TRISTAN PENNELLA DO
101 MARTIN LUTHER KING DR
MANKATO, MN 56001-6460
Phone number: 507-594-6572
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Mailing Address
TRISTAN PENNELLA DO
101 MARTIN LUTHER KING DR
MANKATO, MN 56001-6460
Phone number: 507-594-6572
Copy
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