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1861607384
JACK PENAFIEL
BALTIMORE, MD
NPI
1861607384
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MD A00483)
Enumeration Date
2007-05-10
Last Update Date
2007-07-08
Business Address
Mr. JACK PENAFIEL OTAL
7960 SCOTT LEVEL
BALTIMORE, MD 21208
Phone number: 410-521-3600
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Mailing Address
Mr. JACK PENAFIEL OTAL
9860 BALE CT
OWINGS MILLS, MD 21117-6386
Phone number: 443-827-0876
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