Doctor Name: | PENNI JO ROMERO |
NPI Number: | 1104949833 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T., M.S |
License Number: | 620 |
Business Practice Address: | 3460 Piney Creek Dr Elkhorn, NE - 680224420 |
Business Phone Number: | 4022890053 |
Business Fax Number: | |
Mailing Address: | 3460 Piney Creek Dr, ELKHORN |
State: | NE |
Postal Code: | 680224420 |
Phone Number: | 4022890053 |
Fax Number: | |
NPI Enumeration Date: | 04/09/2007 |
NPI Last Update Date: | 02/21/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | 620 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |