Bruce R Penn Inc

NPI 1023255684 - Social Worker - 1041C0700X

NPI Details
NPI 1023255684
Enumeration Date 01/19/2009
Last Updated 01/19/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name NANCY F NANCY
Position AUTHORIZED OFFICIAL
Phone (770) 908-1746
Fax
Practice Location
5165 LAVISTA RD
TUCKER GA, 30084-3602, US
Phone (770) 908-1746
Fax
Business Location
4378 SLEEPY HOLLOW CV
LILBURN GA, 30047-4196, US
Phone
Fax
Toxanomy
Taxonomy Code 1041C0700X
License State Georgia
License Number CSW002606
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According to our database, Bruce R Penn Inc NPI is 1023255684, taxonomy code is 1041C0700X and license number is CSW002606, license state is located at Georgia. Bruce R Penn Inc physically located at 5165 Lavista Rd, Tucker GA, 30084-3602. NPI Number 1033115704 has the healthcare provider type.

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1023255684 NPI number is provided on an as is basis without warranty of any kind. 1023255684 is maintained by the National Plan & Provider Enumeration System. The contents of Bruce R Penn Inc are for informational purposes only.