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1366714917
WILLIAM D PENNER
LAS CRUCES, NM
NPI
1366714917
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: NM 2505)
Enumeration Date
2012-01-29
Last Update Date
2012-01-29
Business Address
-- WILLIAM D PENNER COTA/L
3734 PIEDRAS NEGRAS DR
LAS CRUCES, NM 88012-7671
Phone number: 575-642-0920
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Mailing Address
-- WILLIAM D PENNER COTA/L
3734 PIEDRAS NEGRAS DR
LAS CRUCES, NM 88012-7671
Phone number: 575-642-0920
Copy
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