Doctor Name: | PENNY TREVITHICK |
NPI Number: | 1124357082 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CBS |
License Number: | 5095BF |
Business Practice Address: | 8380 Hygiene Rd Longmont, CO - 80503 |
Business Phone Number: | 3035797003 |
Business Fax Number: | |
Mailing Address: | P.o. Box 145, HYGIENE |
State: | CO |
Postal Code: | 80533 |
Phone Number: | 3035797003 |
Fax Number: | |
NPI Enumeration Date: | 12/23/2009 |
NPI Last Update Date: | 12/23/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 5095BF |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |